title: Using telehealth interventions to prevent pressure ulcers in newly injured spinal cord injury patients post-discharge. Results from a pilot study.
abstract: OBJECTIVE
  To determine which of three approaches to care produces the lowest incidence of pressure ulcers, promotes the most effective care of sores that develop, and leads to the fewest hospitalizations in newly injured patients with spinal cord injury after discharge.
  
  
  METHODS
  Spinal cord injury patients (n = 12) were recruited for a telehealth intervention after initial injury, and matched cases were recruited for telephone counseling and standard care groups. Patients were monitored for 6-8 months after discharge.
  
  
  RESULTS
  The video group had the greatest number of reported and identified pressure ulcers. Differences in health care utilization between the video and telephone telehealth groups were small. The standard care group reported the lowest number of pressure ulcers and lowest frequency of health care utilization. Substantial differences existed in employment rates before and after injury. The video group had the lowest pre-injury rate of employment and the highest post-injury rate of employment.
  
  
  CONCLUSIONS
  Tracking pressure ulcer incidence, particularly stage I sores, is difficult. Self-report is likely to lead to substantial underreporting. Similarly, self-report on health care utilization over extended periods may lead to undercounting of encounters. Telehealth interventions appear to improve ulcer tracking and management of all ulcer occurrences. Video interventions may affect outcomes, such as employment rates, which are not conventionally measured.
authors.affiliation: Emory University, USA.
authors.forename: V L
authors.initials: VL
authors.lastname: Phillips
authors.forename: A
authors.initials: A
authors.lastname: Temkin
authors.forename: S
authors.initials: S
authors.lastname: Vesmarovich
authors.forename: R
authors.initials: R
authors.lastname: Burns
authors.forename: L
authors.initials: L
authors.lastname: Idleman
mesh_terms: D000328:Adult; D000359:Aftercare / Q000379:methods*; D003695:Delivery of Health Care / Q000706:statistics & numerical data; D004651:Employment / Q000706:statistics & numerical data; D005260:Female; D005845:Georgia; D006801:Humans; D015994:Incidence; D008297:Male; D010353:Patient Education as Topic / Q000379:methods*; D010865:Pilot Projects; D003668:Pressure Ulcer / Q000209:etiology / Q000517:prevention & control*; D015397:Program Evaluation; D012047:Rehabilitation Centers; D013119:Spinal Cord Injuries / Q000150:complications*; D017216:Telemedicine / Q000379:methods*; D013689:Telephone; D016896:Treatment Outcome; D014743:Videotape Recording