A feasibility study of a telephone-supported self-care intervention for depression among adults with a comorbid chronic physical illness in primary care.

Jane McCusker · Martín G. Cole · Mark J. Yaffe⃰ · Tamara Sussman · Kim Louise Lavoie · Erin Strumpf +2 more

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Digital Mental Health Interventions Mental Health Treatment and Access Telemedicine and Telehealth Implementation

Abstract

Objective We assessed the feasibility and acceptability to patients of a telephone-supported self-care intervention for depression among adults aged 40 years or over with one of six targeted chronic physical illnesses and comorbid depressive symptoms in family practice settings. Methods An open, uncontrolled trial (feasibility study) was conducted among patients treated in Montreal family practices. Eligible patients were aged 40 years or over, had one or more of the targeted chronic physical illnesses for at least 6 months (arthritis, hypertension, diabetes, heart disease, asthma and chronic obstructive pulmonary disease) and were evaluated as having at least mild depressive symptoms (a score of ≥ 5 on the 9-item Patient Health Questionnaire, PHQ-9). Participants received a package of six self-care tools (information booklet, video, Internet programme, action plan, workbook and mood-monitoring tool) with telephone support by a lay coach for up to 6 months. Results In total, 63 eligible patients provided written consent and completed the baseline interview; 57 (90%) and 55 (87%) patients completed 2-month and 6-month follow-up interviews, respectively. The mean number of telephone calls made by coaches to participants was 10.5 (SD 4.0), and the average length of these calls was 10.6 minutes. At the 6-month follow-up, 83.6% of the participants reported that one or more of the tools were helpful. Clinically significant improvements were seen in depressive symptoms (as assessed by the PHQ-9) at 6 months, with an effect size of 0.88 (95% CI, 0.55, 1.14). Conclusion A telephone-supported self-care intervention for depression was feasible, was acceptable to patients, and was associated with a significant 6-month improvement in depressive symptoms. A randomised trial of this intervention is justified.

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References

1996A 12-Item Short-Form Health Survey 1999Validation and Utility of a Self-report Version of PRIME-MD The PHQ Primary Care Study 2012Cognitive Therapy for Depression 1989Health Measurement Scales: A Practical Guide to Their Development and Use 2004Development of the Patient Activation Measure (PAM): Conceptualizing and Measuring Activation in Patients and Consumers 1994Utility of a new procedure for diagnosing mental disorders in primary care. The PRIME-MD 1000 study 2005Development and Testing of a Short Form of the Patient Activation Measure 1997Case-finding instruments for depression

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