Will a nurse and social worker telecare team improve quality of life for my lung disease?

For people with interstitial lung disease (ILD), managing symptoms and maintaining quality of life can be challenging. A recent study tested whether a team of a nurse and a social worker providing phone-based support could help. The answer is yes: the ADAPT trial found that this telecare team significantly improved quality of life, disease-specific health status, depression, and anxiety in high-risk patients with ILD, COPD, or heart failure ⁴⁹¹⁰. The intervention involved about 6 phone calls with a nurse and 6 with a social worker over roughly 4 months, plus weekly team meetings with physicians ⁴⁹¹⁰.

What the research says

The ADAPT randomized clinical trial, published in JAMA in 2024, included 306 outpatients with COPD, heart failure, or interstitial lung disease who were at high risk of hospitalization or death and reported poor quality of life ⁹. Patients were randomly assigned to either the telecare team intervention or usual care (which included an educational handout) ⁹. The intervention consisted of 6 phone calls with a nurse focused on symptom management and 6 phone calls with a social worker for psychosocial support ⁴⁹¹⁰. The nurse and social worker met weekly with a primary care physician, a palliative care physician, and, as needed, a pulmonologist or cardiologist ⁹.

Results showed that the telecare team led to statistically significant improvements in quality of life, disease-specific health status, depression, and anxiety compared to usual care ⁴⁹. A separate analysis of the intervention's process and cost found that participants averaged 10 sessions with the nurse and 9.5 sessions with the social worker over about 115 days ⁴¹⁰. The team made an average of 7 recommendations per participant, most commonly referrals to other services (79.7%), medication additions (58.1%) or changes (31.8%), and tests (33.1%) ⁴¹⁰. The average cost to deliver the intervention per patient was $1,139.68 ⁴¹⁰.

Importantly, the trial specifically included patients with interstitial lung disease, so the findings apply directly to your condition ⁹. The study was conducted at two Veterans Administration health care systems, so results may vary in other settings ⁹. Overall, the evidence supports that a nurse and social worker telecare team can meaningfully improve quality of life for people with ILD.

What to ask your doctor

• Would a palliative care referral or a nurse-social worker telecare program be available or appropriate for my ILD?
• How can I access symptom management support, such as phone-based nursing or social work services?
• Are there any local programs similar to the ADAPT trial that I could join?
• What other non-drug approaches (like fan therapy for breathlessness) might help my symptoms?
• Could a social worker help me with anxiety, depression, or care coordination related to my lung disease?