Baseline Psychological Treatment Reduces the Effect of Coaching in a Randomised Trial of a Depression Self-Care Intervention

Jane McCusker · Martín G. Cole · Sylvie Lambert · Mark J. Yaffe⃰ · Antonio Ciampi · Éric Belzile

9 citations0/0 files storedThe Canadian Journal of Psychiatry

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

Abstract

OBJECTIVE: To explore the effects of baseline psychological and antidepressant medication treatment in a trial of lay telephone coaching in a low-intensity, supported depression self-care intervention. METHOD: A single blind, individually randomised, pragmatic trial was conducted among primary care adults with chronic physical conditions and comorbid depressive symptoms. Eligible subjects were randomised to receive a depression self-care toolkit with (intervention group) or without (control group) telephone coaching provided by trained lay coaches. For this brief communication, a secondary analysis of the trial data focused on the effects of baseline psychological and antidepressant treatments on mental health outcomes (Patient Health Questionnaire 9 [PHQ-9], SF-12 Mental Component Summary [MCS], Generalized Anxiety Disorder 7 [GAD-7]) and satisfaction with the intervention. RESULTS: In total, 223 patients were randomised, and 165 (74.0%) completed both 3- and 6-month follow-ups. There were 2 significant interactions of baseline treatment and study group for 6-month mental health outcomes. A significant benefit of coaching on 6-month PHQ-9 was seen only among participants who were not receiving baseline psychological treatment. A smaller interaction was found for baseline antidepressant medications and 6-month mental health. There was a significant main effect for baseline psychological treatment and lower 6-month satisfaction. CONCLUSIONS: Depressed patients receiving baseline psychological treatment may not benefit from lay coaching offered as part of a low-intensity depression self-care intervention.

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References

2006A Brief Measure for Assessing Generalized Anxiety Disorder 1996A 12-Item Short-Form Health Survey 2003Measuring depression outcome with a brief self-report instrument: sensitivity to change of the Patient Health Questionnaire (PHQ-9)2004Monitoring Depression Treatment Outcomes With the Patient Health Questionnaire-9 2008Psychotherapy versus the combination of psychotherapy and pharmacotherapy in the treatment of depression: a meta-analysis 2011Methodological criteria for the assessment of moderators in systematic reviews of randomised controlled trials: a consensus study 2015A randomized trial of a depression self-care toolkit with or without lay telephone coaching for primary care patients with chronic physical conditions

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