Related Experiment Videos
A pilot randomized controlled trial of an outreach intervention to improve depression treatment initiation among
Vanessa Simiola1, Kathryn K Ridout2, Catherine Erickson1
1Kaiser Permanente, Center for Integrated Health Care Research, Honolulu, HI, United States of America.
Background:
Even after recognition of depression in primary care, rates of treatment initiation remain low, particularly among some racial and ethnic groups. This pilot randomized controlled trial examined the feasibility and preliminary efficacy of a tailored outreach intervention to improve depression treatment initiation.
Methods:
Across two health systems, 309 adults from Asian, Native Hawaiian, Other Pacific Islander, Black or African American, and Hispanic backgrounds who received a new depression diagnosis in primary care but failed to initiate treatment within 30 days were randomized 1:1 to usual care or the outreach intervention. The intervention utilized patient portal messages or telephone contact based on depression severity, employing motivational interviewing techniques. The primary outcome was treatment initiation within 60-days post-randomization.
Results:
Nearly three quarters (72%) of intervention participants were successfully reached. The intervention group demonstrated significantly higher treatment initiation rates compared to usual care (24.2% vs. 5.9%, p < .001), representing a four-fold increase. Participants who were reached were more likely to initiate treatment than those not reached (31.9% vs. 4.5%, p < .001). Both groups showed significant reductions in PHQ-9 scores at follow-up.
Conclusions:
This pilot trial demonstrates that a staged outreach intervention using patient portals and telephone contact is feasible and shows promise for improving depression treatment initiation in racial and ethnic groups historically less likely to initiate treatment.
