A pilot randomized controlled trial of a depression and disease management program delivered by phone.
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.
['Aburizik|Arwa|A|', 'Dindo|Lilian|L|', 'Kaboli|Peter|P|', 'Charlton|Mary|M|', 'Dawn|Klein|K|', 'Turvey|Carolyn|C|']
D000368:Aged D002908:Chronic Disease D059350:Chronic Pain D003863:Depression D003920:Diabetes Mellitus D019468:Disease Management D005260:Female D006801:Humans D006973:Hypertension D008297:Male D008875:Middle Aged D010865:Pilot Projects D017216:Telemedicine D014728:Veterans
Depression Telehealth Diabetes Hypertension Chronic pain Chronic illness