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Technology-Assisted Collaborative Care Program for People with Diabetes and/or High Blood Pressure Attending Primary
Pablo Martínez1,2,3,4,5, Viviana Guajardo1,2,6, Víctor E Gómez1,2,7,8,9
1Departamento de Psiquiatría y Salud Mental, Hospital Clínico Universidad de Chile, Santiago 8431617, Chile.
International Journal of Environmental Research and Public Health
|November 27, 2021
Summary
A technology-assisted collaborative care program showed promise for treating depression in patients with diabetes and/or high blood pressure. The intervention was partially feasible and potentially effective, improving mental health and treatment adherence.
Area of Science:
- Clinical Medicine
- Public Health
- Digital Health
Background:
- Comorbidity of depression with chronic physical diseases like diabetes and high blood pressure is often overlooked in clinical practice.
- Primary healthcare settings present a crucial opportunity for integrated mental and physical health management.
- Existing guidelines inadequately address the dual burden of chronic disease and depression.
Purpose of the Study:
- To evaluate the feasibility and potential efficacy of a technology-assisted collaborative care (TCC) program for depression.
- To assess the TCC program's impact on depressive symptoms, quality of life, and treatment adherence in patients with diabetes and/or high blood pressure (DM/HBP).
- To gather preliminary data for a future randomized clinical trial on TCC for DM/HBP patients with depression.
Main Methods:
- A pilot study involving 20 patients with DM/HBP and depressive symptoms (Patient Health Questionnaire-9 score ≥ 15) in a primary healthcare facility.
- The TCC program included computer-assisted psychosocial intervention (CPI), telephone monitoring (TM), and a behavioral activation mobile app (CONEMO).
- Feasibility was assessed by completion rates; efficacy was measured by changes in depressive symptoms and other health outcomes at 12 weeks.
Main Results:
- 13 patients completed the CPI, and 12 received TM; the mobile app (CONEMO) was not utilized.
- Two-thirds of participants achieved a response to depression treatment by 12 weeks.
- Significant decreases in depressive symptoms and healthcare visits were observed, alongside improvements in mental health-related quality of life and treatment adherence.
Conclusions:
- The TCC program was partially feasible and demonstrated potential efficacy in managing depression among patients with DM/HBP.
- The computer-assisted psychosocial intervention component was perceived as acceptable by patients.
- Findings support the TCC model as a viable approach for integrated care and warrant further investigation in a randomized clinical trial.
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