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Telemedicine may ease chronic pain

Telecare may ease chronic pain

A telemedicine program using automated phone calls or the Internet to monitor symptoms and tailor drug treatment might help patients with chronic pain improve their condition, a new study found.

Researchers at Indiana University School of Medicine randomly assigned 250 patients with chronic musculoskeletal pain to receive either telecare or standard care from their primary care doctor at a Veterans Administration medical center. Patients in the telecare group reported their pain levels through an interactive voice-recorded call or online, and their answers guided adjustments to their medications, based on an algorithm.

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After one year, the telecare patients were nearly twice as likely to report a 30 percent improvement in their pain compared with those who received standard care, and they were more likely to report feeling satisfied with their treatment. Those who received standard care were almost twice as likely to report feeling worse pain after six months compared with the telecare group.

BOTTOM LINE: A program using phone calls or the Internet to monitor symptoms and tailor care might help patients with chronic pain improve their condition.

CAUTIONS: Participants consisted of veterans from a single medical center so the findings may not apply to a wider group. The study relied on self-reports of pain, which may not be accurate.

WHERE TO FIND IT: Journal of the American Medical Association, July 16

Treatment of low-risk prostate cancer
varies by doctor

Treatment for low-risk prostate cancer might depend on the specialist diagnosing the condition rather than the characteristics of the disease, MD Anderson Cancer Center researchers found.

The study involved more than 12,000 men age 66 and older who were diagnosed by a urologist with low-risk prostate cancer between 2006 and 2008. Eighty percent of the men received treatment including prostatectomy or external-beam radiotherapy, while 20 percent chose active surveillance.

Active surveillance is often the preferred way of managing low-risk prostate cancer in older men, because they experience fewer complications and live about as long, according to previous research. But the 2,145 urologists in the study varied widely in the proportion of their patients following this approach: from 4.5 percent to 64 percent. Urologists who typically treat more aggressive forms of prostate cancer and those who graduated from medical school before 1980 were more likely to have their patients undergo treatment rather than active surveillance.

Men who saw only a urologist were more likely to undergo active surveillance than patients who also saw a radiation oncologist, and men were more likely to undergo radical prostatectomy if the diagnosing urologist performed that type of surgery.

BOTTOM LINE: Treatment for low-risk prostate cancer may depend on the specialist diagnosing the condition rather than the characteristics of the disease.

CAUTIONS: The study did not look at the outcomes of patients who underwent treatment versus those who chose active surveillance.

WHERE TO FIND IT: JAMA Internal Medicine, July 14


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