Jane McCusker1,2, Martin Cole3,4, Sylvie Lambert2,5, Mark Yaffe6,7, Antonio Ciampi1,2, Eric Belzile2. 1. 1 Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec. 2. 2 St. Mary's Research Centre, Montreal, Quebec. 3. 3 Department of Psychiatry, McGill University, Montreal, Quebec. 4. 4 Geriatric Psychiatry Division, St. Mary's Hospital Center, Montreal, Quebec. 5. 5 Ingram School of Nursing, McGill University, Montreal, Quebec. 6. 6 Department of Family Medicine, McGill University, Montreal, Quebec. 7. 7 Family Medicine Centre, St. Mary's Hospital Center, Montreal, Quebec.
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.
RCT Entities:
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.
Authors: Sara T Brookes; Elise Whitely; Matthias Egger; George Davey Smith; Paul A Mulheran; Tim J Peters Journal: J Clin Epidemiol Date: 2004-03 Impact factor: 6.437
Authors: Jane McCusker; Martin G Cole; Mark Yaffe; Erin Strumpf; Maida Sewitch; Tamara Sussman; Antonio Ciampi; Kim Lavoie; Robert W Platt; Eric Belzile Journal: Gen Hosp Psychiatry Date: 2015-03-18 Impact factor: 3.238
Authors: Tamar Pincus; Clare Miles; Robert Froud; Martin Underwood; Dawn Carnes; Stephanie J C Taylor Journal: BMC Med Res Methodol Date: 2011-01-31 Impact factor: 4.615