Health care providers often find it difficult to monitor the behavioral changes that are important components of treatment for patients with chronic illnesses. Older patients in particular may present problems of compliance with instructions and adherence to medical regimens. Additionally, elderly patients with chronic illnesses may be susceptible to mood disorders which further decrease the likelihood of compliance. This project uses a therapeutic model that allows a provider to establish specific behavioral goals for a patient and monitor the patient's progress through daily computer-initiated telephone interactions. Patients respond to pre-recorded questions which reinforce their progress toward their behavioral goals. Telephone interactions also educate, motivate and reassure patients. The long-term objectives of the project are to improve compliance with treatment regimens; to improve patients' perceived health status; and to reduce the cost of providing care. In Phase I of this project we will modify the existing computer program to address the needs of older patients and conduct a small-scale outcome study comparing the effectiveness of the program with traditional clinical follow-up care. Phase II will consist of a large-scale efficacy trial.
