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Remote Collaborative Depression Care Program for Adolescents in Araucanía Region, Chile: Randomized Controlled Trial
Vania Martínez1,2, Graciela Rojas2,3, Pablo Martínez2,4,5
1Centro de Medicina Reproductiva y Desarrollo Integral del Adolescente, Facultad de Medicina, Universidad de Chile, Santiago, Chile.
Journal of Medical Internet Research
|February 2, 2018
Summary
Remote collaborative depression care (RCDC) was feasible and well-accepted by adolescents and clinicians in Chile. While not improving symptoms, RCDC increased satisfaction with psychological care, highlighting its potential for underserved populations.
Area of Science:
- Mental Health
- Adolescent Psychiatry
- Telemedicine
Background:
- Many adolescents with depression lack access to evidence-based treatment.
- Remote collaborative depression care (RCDC) can bridge this gap.
- This study focuses on adolescents in Chile's Araucanía Region.
Purpose of the Study:
- To assess the feasibility, acceptability, and effectiveness of RCDC for adolescents with major depressive disorder (MDD).
Main Methods:
- A cluster randomized trial involving 143 adolescents (13-19 years) with MDD across 16 primary care centers.
- Intervention group received 3-month RCDC with remote psychiatric supervision via shared electronic health records (SEHR) and phone monitoring.
- Control group received enhanced usual care (EUC).
Main Results:
- Recruitment exceeded 60% of the target sample size, with a 90.9% response rate at 12 weeks.
- Adolescents in the RCDC group reported higher satisfaction with psychological assistance compared to EUC.
- No significant differences in depressive symptoms or health-related quality of life (HRQoL) were found between groups.
- Clinician satisfaction with the RCDC intervention was high.
Conclusions:
- RCDC is a feasible and well-accepted intervention for adolescents with MDD from vulnerable backgrounds in Latin America.
- Implementation factors may explain the comparable effectiveness between RCDC and EUC.
- The intervention's effectiveness appears comparable to established nationwide programs.
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