telemedicine

Posted on Diabetes

Empathetic telephone calls improve diabetes control in low-income adults, study shows

Empathy-focused phone calls made by trained, nonmedical community members led to significant improvements in blood sugar control for low-income adults with diabetes, according to a new study from Dell Medical School at The University of Texas at Austin in collaboration with Lone Star Circle of Care. Published today in JAMA Network Open, the study suggests this approach could provide a simple, cost-effective model for managing chronic conditions, particularly for patients with limited access to traditional mental health and support services.
A recent study conducted by Dell Medical School at The University of Texas at Austin, in collaboration with Lone Star Circle of Care, found that empathy-focused phone calls made by trained community members (who are not medical professionals) led to significant improvements in blood sugar control among low-income adults with diabetes. Published today in JAMA Network Open, the study suggests that this approach could serve as a simple and cost-effective model for managing chronic conditions, especially for patients who have limited access to traditional mental health and support services.

In a six-month clinical trial, 260 patients with uncontrolled diabetes were randomly divided into two groups. One group received standard care, while the other received standard care and regular phone calls that emphasized listening and empathy. These calls were made by community members who were trained to provide compassionate support, allowing participants to share their experiences and challenges related to living with diabetes.

“This approach starts by recognizing the real and everyday challenges of living with diabetes,” said Maninder “Mini” Kahlon, Ph.D., the study’s lead author and an associate professor in the Department of Population Health at Dell Med. “By providing sincere and empathetic support, we achieved a health impact equivalent to taking medication. This is because emotional well-being serves as the gateway to the lifestyle changes that enhance the management of the condition—an area where traditional healthcare often falls short.”

Key findings include:

  • Improved Blood Sugar Control: Patients who received empathy-based calls saw an average HbA1c reduction of 0.7%, compared with no significant change in the control group.
  • Greater Impact for Patients With Mild or Greater Depressive Symptoms: Patients reporting mild depressive symptoms saw even larger reductions, with average HbA1c improvements of 1.1%.
  • High Satisfaction: Nearly all participants receiving the calls rated them as very or extremely beneficial to their well-being.

All study participants, who were patients of the Lone Star Circle of Care, had the flexibility to choose how often and for how long they wanted to engage in calls. During the initial stages, they could select between one and five calls per week, gradually tapering as they made progress. This patient-driven approach empowered individuals to receive support at a pace that met their needs and schedules. It helped foster a strong connection with their callers while reinforcing their self-care routines.

“At a time when workforce shortages challenge health care delivery, this study underscores the profound clinical impact nonclinical staff can make,” said Jon Calvin, CEO of Lone Star Circle of Care. “By leveraging trained laypeople, we’re demonstrating that empathy, connection and intentional engagement can lead to measurable health improvements. In a world where medicine is increasingly fast-paced and technology-driven, this work reminds us that human connection remains at the heart of effective care. Empathy not only enhances patient engagement but empowers individuals to take meaningful steps toward better health outcomes.”

This research builds on previous studies highlighting the benefits of empathetic phone calls. In 2021, Kahlon and her team published a study that found “Sunshine Calls”—a series of regular, genuine phone calls made by individuals who were not healthcare professionals—showed promise in alleviating loneliness, depression, and anxiety, as well as improving overall mental health among mainly homebound older adults.

Both studies were funded by the Episcopal Health Foundation, which focuses on person-centered, nonmedical approaches to health.

Looking ahead, researchers hope to explore the long-term effects of empathy-based support on both diabetes control and broader mental health. They also plan to scale this model, aiming to make holistic, empathetic support more widely available to those in need.

Posted on Pain Management

Telephone-based therapy and exercise appear effective for reducing chronic widespread pain

Telephone-based therapy and exercise appear effective for reducing chronic widespread pain
Telephone-based therapy and exercise appear effective for reducing chronic widespread pain



Telephone-delivered cognitive behavioral therapy and an exercise program, both separately and combined, are associated with short-term positive outcomes for patients with chronic widespread pain, and may offer benefits for patients diagnosed with fibromyalgia, according to a report published Online First by Archives of Internal Medicine, one of the JAMA/Archives journals.

“In the United States, mean [average] per-patient costs (including pain and non-pain-related medication, physician consultations, tests and procedures, and emergency department visits) in the six months following a new diagnosis of fibromyalgia were $3,481,” the authors write as background information in the article. “There is a need to develop clinically effective and cost-effective, acceptable interventions at a primary care level that could potentially be available to a large number of patients.”

John McBeth, M.A., Ph.D., then of the Arthritis Research U.K. Epidemiology Unit, University of Manchester, England, now of the Arthritis Research U.K. Primary Care Centre, Keele University, Staffordshire, England, and colleagues conducted a randomized controlled trial to assess the effects of a telephone-based cognitive behavioral therapy, exercise, or a combined intervention among patients with chronic widespread pain.

The authors randomized 442 patients with chronic widespread pain to receive six months of telephone-delivered cognitive behavioral therapy (TCBT), graded exercise, combined intervention, or treatment as usual (control group). The primary outcome was self-rated score measuring how patients felt their health had changed since the period prior to entering the trial, which was measured using a 7-point scale on a questionnaire or telephone interview conducted by study personnel. A “positive outcome” was defined as feeling “much better” or “very much better.”

After six months (end of the intervention period), 8.1 percent of participants in the control group reported positive outcomes, compared with 29.9 percent of the TCBT group, 34.8 percent of the exercise group and 37.2 percent of the combined intervention group. Results were similar at the nine-month follow-up, with 8.3 percent of participants in the control group, 32.6 percent of the TCBT group, 24.2 percent of the exercise group and 37.1 percent of the combined intervention group reporting positive outcomes.

At the six and nine-month follow-ups, the combined intervention was associated with improvements in the 6-Item Short Form Health Questionnaire physical component score and a reduction in passive coping strategies.

“This trial demonstrates short- to medium-term improvements in patients with chronic widespread pain,” the authors conclude. “Whether improvements continue in the longer term should be established. These results provide encouragement that short-term improvement is possible in a substantial proportion of patients with chronic widespread pain.”

Posted on Diabetes

Tele-diabetes to manage new-onset diabetes during COVID-19 pandemic

Two new case studies highlight the use of tele-diabetes to manage new-onset type 1 diabetes in an adult and an infant during the COVID-19 pandemic. The article describing these experiences and providing perspectives on the future application of tele-diabetes is published in Diabetes Technology & Therapeutics (DTT), a peer-reviewed journal from Mary Ann Liebert, Inc., publishers. Click here (https://www.liebertpub.com/doi/10.1089/dia.2020.0161) to read the full-text article free on the Diabetes Technology & Therapeutics (DTT) website.

The article entitled “Managing New-Onset Type 1 Diabetes During COVID-19 Pandemic: Challenges and Opportunities” is coauthored by DTT Editor-in-Chief Satish Garg, University of Colorado (Aurora), David Rodbard, Biomedical Informatics Consultants LLC (Potomac, Maryland), Irl Hirsch, University of Washington (Seattle), and Gregory Forlenza, University of Colorado (Aurora).

The first patient was a 20-year-old who was treated in the hospital for a few days and then managed virtually. He was treated with multiple daily injections of insulin and a continuous glucose monitor, with data upload to his caregivers to facilitate virtual management of his diabetes. The physician adjusted his insulin dose every day. His initial time-in-range (TIR) was 16%, which improved to 58% after 2 weeks of virtual management, and at 3 weeks the TIR was at 90%.

The second patient was a 12-month-old who was started on an insulin pump and a continuous glucose monitor. The family was taught how to upload the insulin pump data via their home computer, using a software account linked to the hospital. The continuous glucose monitor was set up on a cell phone worn by the child on a fanny pack, with remote monitoring by both the parents and continuous connectivity to software linked to the hospital account. The physician made daily dose adjustments via phone or email based on the data received.

“The COVID-19 pandemic has forced many providers to look for alternative approaches to manage high-risk patients with new-onset type 1 diabetes through Telehealth, especially by employing new technologies like Dexcom G6 CGM and Clarity App. Since many of the long-standing regulations were removed during this pandemic along with similar reimbursements for Tele-visits, Telehealth, or Virtual patient visits, these have become a popular method of delivering care for both new-onset patients with type 1 diabetes and for established patients, with similar or even better outcomes,” says DTT Editor-in-Chief Satish Garg, MD, Professor of Medicine and Pediatrics at the University of Colorado Denver (Aurora).

Leave a comment Posted on Healthcare and technology

Why is telemedicine the main trend in healthcare today?

As regular readers know I’m a massive fan of the use of new and digital technologies in medicine

Over the last year or two one of the main drums I’ve been beating is the rise (irresistible) of telemedicine.

You may be interest in some of our previous coverage here and here.

So I was particularly delighted to find this infographic which introduces you to the concept of telemedicine in very straight forward terms.

What do you think of the concept of telemedicine? Please do share your view in the comments section below?


Please include attribution to www.inhousephysicians.com with this graphic.

’Healthcare

Leave a comment Posted on Patient Talk, Social media

Millions fear end of current healthcare says recent research. How technology might fill the gap.


Chris Millington of Doro

Chris Millington of Doro

Concerns about the NHS and its future are so great for almost 40% of the population that they fear it won’t even exist when they reach old age.

That’s according to new research released today which saw almost 60% say they are worried the NHS won’t be able to look after them when they get older, with 41% saying budget cuts have them fearing for the future of the health service.

More than 40% surveyed by Doro also say they worry about Britain’s ageing population will mean for health care in years to come.

More than one in five have even more immediate concerns about whether the NHS will even be able to care for their parents or elderly relatives.

And with one in seven worrying they won’t have the money to care for their parents or elderly relatives when the time comes and one in ten concerned they won’t have the time, the study raises questions over just who will look after our ageing population.

Almost a third also worry about how isolated their parents may become when they get older, while around 40% believe technology is contributing to isolation instead of helping them feel more connected and supported.

However, with more than half of respondents saying their elderly relatives now use at least one form of smart technology such as smart phones, social media, or tablets, could the growing number of apps, monitoring services and websites dedicated to health actually be a huge part of the solution to the growing crisis over care of the elderly?

We interview Chris Millington MD of Doro to find out more.


PATIENTTALK.ORG How has the NHS changed since Nye Bevan in terms of operations, objectives and outcomes?

MILLINGTON Well obviously Nye Bevan were given the task of creating a national health service or a

Doro - Telemedicine

Doro – Telemedicine

free to use health service so in the early days it was created from gathering together all of the elements that were out there in the private sector. It’s a very different organization now, in fact that’s the most important thing. It is an organization now, it wasn’t then. So it has an operation and it has a very difficult task of trying to provide the best outcomes possible for the nation as a whole and we spend 6% of our GDP and rising dramatically on the cost of providing some immense health care.

PATIENTTALK.ORG Is it not outmoded in the new era of both management style and medical technology?

MILLINGTON I think that it will always lag behind the amazing things that happen within technology and also treatments. You think of all the amazing things that have happened to treat things like cancer and the technology that leaps forwards, the NHS has got to provide the services that links those things together so it is always going to be a challenge. To say it is completely outmoded in this era I think is too challenging to the health service and it provides great support. It just needs to engage further with technology.

PATIENTTALK.ORG What are the main reasons for the failure of the NHS in your view?

MILLINGTON The NHS is always going to creak at the seams because of the demands that are placed upon it and the fact that we all know that we are going to have to pay for this health service, this ever increasing health service. To say it’s failed is probably a bit premature, it potentially could if it doesn’t change, if it doesn’t adapt to the future requirements and one of the things that we are looking at in our research is how people feel about these areas, so we know that people are concerned that potentially there might not be an NHS or that there might not be services when they retire and come to need them. And that’s simply because the aging population is expanding at a massive rate and as it does and it becomes 20%, well it is 20% of our population today but it will head towards 30% within 15 – 20 years and that’s a fairly serious number of users that will rely on the NHS to treat their everyday conditions.

PATIENTTALK.ORG So what should replace the NHS and how should it be funded?

MILLINGTON I would rather focus on how we help the NHS to perform better through the use of technology. I think that the politicians need to look at funding levels and things like that rather than an organisation or a person like myself, the most important thing is how we get more out of the current provision of health care in this country and technology can really change the dynamics of the business model that is there today. If 70% of our GP appointments of people over the age of 65 managing everyday conditions like diabetes, technology can remove the vast majority of those everyday appointments by gathering the information and reporting it automatically to GP’s to be able to act upon any changes rather than just simply turning up and delivering their results and doing yet another blood test and then going away having wasted another hour of their time and potentially an hour the GP’s time, so you can really target resources much better by making technology work to identify real issues and therefore free up the time and resource to help the GP’s to do a different job.

PATIENTTALK.ORG Is the strangle hold of GP’s over the NHS the main problem?

MILLINGTON So again I think my previous point is that you can free up the time of the GP’s. I think that if you ask the GP they’d feel like they were being strangled by the immense pressure they are put under to cope with the number of patients that they are seeing every single day. Again technology can play an immense role in freeing up their time to enable them to make better diagnosis and help people that are in need of that help rather than simply just take results and pass them on in a recording process, an administration process.

PATIENTTALK.ORG How exactly can telemedicine improve health care?

MILLINGTON We can talk about telemedicine or mobile health but effectively what you’re doing is using everyday technology so you can use a mobile phone or a tablet to gather information, to report statistics, to healthcare systems, so a computer can quite easily handle a lot of the data and provide the GP the information to better than act upon the changes and ultimately what you’re looking for are changes in people’s health and wellbeing and therefore you can intervene on whether they need to be admitted to a hospital or whether they need some care or some medication. If you wait until that point where there at a GP, it’s already too late, they’re already in need of that medication or healthcare so if you can reduce the number of visits by taking the readings and measurements through technology that makes a massive difference.

PATIENTTALK.ORG – With the end of the current NHS, how will healthcare improve in the UK?
MILLINGTON I don’t think the NHS is going to end, I think the NHS will adapt and evolve and as a nation we’re going to demand that it does that anyway. Technology needs to make a more relevant role within making sure the NHS is targeted at what we need as a nation and I think it will, it needs the energy and effort of politicians and the health care service themselves to want to do this, to recognise that there are more and more people over the age of 65 that need treatment and we have to find a way to resource those treatments and technology is the only way for us to save money and provide those resources and treatments in the future.

PATIENTTALK.ORG Where can people go for more information?

MILLINGTON If you want to know more about our products and services that we offer visit then you can visit dora.com or of course find us on the usual social media sites.