Arwa Aburizik1, Lilian Dindo, Peter Kaboli, Mary Charlton, Klein Dawn, Carolyn Turvey. 1. VA Office of Rural Health, Veterans Rural Health Resource Center-Central Region, Iowa City VAMC, Iowa City, IA and the Comprehensive Access and Delivery Research and Evaluation (CADRE) Center at the Iowa City VA Health Care System, Iowa City, IA, United States; Division of General Internal Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa city, IA, United States.
Abstract
BACKGROUND: Depression in medically ill patients occurs at twice the rate found in the general population. Though pharmacologic and psychotherapeutic interventions for depression are effective, response to treatment and access to care are barriers for this population. A multidimensional telehealth intervention was designed to focus on these barriers by delivering a phone based intervention that addressed managing one's illness and coping emotionally. METHODS:Veterans with diabetes, hypertension, or chronic pain and depressive symptoms were randomized to one of three conditions: Usual Care (n=23), Illness Management Only (n=31), or Combined Psychotherapy and Illness Management (n=29). Those randomized to the Combined or Illness Management Only intervention group received 10 phone visits. Veterans in the Combined group received all aspects of the illness management program plus a manualized depression intervention. Subjects completed assessments at baseline, week 5, and 10 to test the main hypothesis that veterans in the Combined condition would have a greater decline in depressive symptoms. RESULTS: The Combined intervention yielded a significant decline in depressive symptoms when compared with Usual Care. However, the there was no significant difference between the Combined and Illness Management Only groups. LIMITATIONS: This is a pilot study with a small sample size relative to a standard randomized controlled trial in psychotherapy. CONCLUSIONS: This telephone-based intervention succeeded in reducing depressive symptoms in veterans with chronic illness. It adds to the building evidence base for providing phone-delivered mental health services.
RCT Entities:
BACKGROUND:Depression in medically ill patients occurs at twice the rate found in the general population. Though pharmacologic and psychotherapeutic interventions for depression are effective, response to treatment and access to care are barriers for this population. A multidimensional telehealth intervention was designed to focus on these barriers by delivering a phone based intervention that addressed managing one's illness and coping emotionally. METHODS: Veterans with diabetes, hypertension, or chronic pain and depressive symptoms were randomized to one of three conditions: Usual Care (n=23), Illness Management Only (n=31), or Combined Psychotherapy and Illness Management (n=29). Those randomized to the Combined or Illness Management Only intervention group received 10 phone visits. Veterans in the Combined group received all aspects of the illness management program plus a manualized depression intervention. Subjects completed assessments at baseline, week 5, and 10 to test the main hypothesis that veterans in the Combined condition would have a greater decline in depressive symptoms. RESULTS: The Combined intervention yielded a significant decline in depressive symptoms when compared with Usual Care. However, the there was no significant difference between the Combined and Illness Management Only groups. LIMITATIONS: This is a pilot study with a small sample size relative to a standard randomized controlled trial in psychotherapy. CONCLUSIONS: This telephone-based intervention succeeded in reducing depressive symptoms in veterans with chronic illness. It adds to the building evidence base for providing phone-delivered mental health services.
Authors: Elizabeth A Kobe; Allison A Lewinski; Amy S Jeffreys; Valerie A Smith; Cynthia J Coffman; Susanne M Danus; Elisabeth Sidoli; Beth D Greck; Leanne Horne; David R Saxon; Susan Shook; Lina E Aguirre; Mary G Esquibel; Clarene Evenson; Christopher Elizagaray; Vivian Nelson; Amanda Zeek; William G Weppner; Stephanie Scodellaro; Cassie J Perdew; George L Jackson; Karen Steinhauser; Hayden B Bosworth; David Edelman; Matthew J Crowley Journal: J Gen Intern Med Date: 2022-01-03 Impact factor: 6.473
Authors: Zhao Ni; Eli R Lebowitz; Zhijie Zou; Honghong Wang; Huaping Liu; Roman Shrestha; Qing Zhang; Jianwei Hu; Shuying Yang; Lei Xu; Jianjun Wu; Frederick L Altice Journal: Res Sq Date: 2020-09-09