[Attitudes of chronically-ill patients to telephone health coaching]. / Einstellungen chronisch Kranker zum telefonischen Gesundheitscoaching.

OBJECTIVE: The aim of this study was to assess the general attitudes of health insurants with chronic conditions towards a health coaching and their reasons for participation in or refusal of the telephone health coaching provided by their sickness fund. METHOD: The survey was designed as a cross-sectional study on insurants who had either participated in the coaching (n=834), declined participation (n=530) or were members of a control group (n=544). Furthermore, we investigated whether the reasons and attitudes differed with regard to socio-demographic variables of the participants (age, sex, primary condition). RESULTS: The most common reason for participation in health coaching was the feeling of obligation towards the society to take care of one's own health (80.1%). Further reasons included a general interest in prevention (75.4%) and health-related issues (51.1%). The main reason for declining participation was a sufficient care by family members or a general practitioner (96.4%). This was in particular the case with older insured persons. Most people in the control group estimated health coaching as effective and appropriate for them. Those who had declined to participate were more critical in their appraisal. The younger the insured were, the more positive was their attitude towards health coaching. CONCLUSIONS: The results show that, on the one hand, insured feel obligated to participate in prevention programs but, on the other hand, they are also interested in information about their condition and in the possibility to contribute to their treatment. The telephone health coaching by the KKH-Allianz is a new approach in the German health care and can be regarded as a supplement to medical treatment. Specifically, younger insured are highly interested in this new concept. Further studies on its efficacy are required to show the extent to which expectations and needs of insurants can actually be met.

Ketotifen in HIV-infected patients: effects on body weight and release of TNF-alpha.

OBJECTIVE: Tumor necrosis factor alpha (TNF-alpha) is involved in the genesis of HIV-associated malnutrition. We performed an open-label trial on the effects of ketotifen, an in vitro inhibitor of TNF-alpha release from peripheral blood mononuclear cells (PBMCs), on the nutritional status and TNF-alpha release of HIV-infected subjects. PATIENTS: Six HIV-infected subjects received oral ketotifen 4 mg per day for 84 days and were followed up for an additional 70-day period. Body composition was measured by bioelectrical impedance analysis. TNF-alpha plasma levels, TNF-alpha release from PBMCs, and plasma concentration of soluble TNF receptors were measured repeatedly during the study and control period. RESULTS: During ketotifen intake, TNF-alpha release from stimulated PBMCs significantly decreased (68 vs 155 pg ml-1), but not TNF-alpha and soluble TNF receptor plasma concentrations. Subjects gained weight (+ 2.7 kg), whereas weight loss was observed after cessation of treatment (-1.6 kg). CONCLUSION: Ketotifen inhibits TNF-alpha release from stimulated PBMCs and might thus be useful in the management of HIV-associated malnutrition.