Effect of Telephone-Delivered Collaborative Goal Setting and Behavioral Activation vs Enhanced Usual Care for Depression Among Adults With Uncontrolled Diabetes

Naik, Aanand D.; Hundt, Natalie E.; Vaughan, Elizabeth M.; Petersen, Nancy J.; Zeno, Darrell; Kunik, Mark E.; Cully, Jeffrey A.

doi:10.1001/jamanetworkopen.2019.8634

Cited by 38 publications

(69 citation statements)

References 57 publications

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“…Approximately 40% of adults are living with multiple chronic conditions in the United States [ 30 ]. It is estimated that about one in three adults with type 2 diabetes experience clinically significant symptoms of depression [ 31 , 32 ]. We did not examine possible associations between depression or anxiety and other health factors.…”

Section: Discussionmentioning

confidence: 99%

Digital Cognitive Behavior Therapy Intervention for Depression and Anxiety: Retrospective Study

Venkatesan¹,

Rahimi²,

Kaur³

et al. 2020

JMIR Ment Health

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Background Digital mental health interventions offer a scalable solution that reduces barriers to seeking care for clinical depression and anxiety. Objective We aimed to examine the effectiveness of a 12-week therapist supported, app-based cognitive behavioral therapy program in improving symptoms of depression and anxiety within 9 months. Methods A total of 323 participants with mild to moderately severe depression or anxiety were enrolled in a 12-week digital cognitive behavior therapy program. The analysis was restricted to participants who provided at least one follow-up assessment after baseline. As a result, 146 participants (45.2%) were included in the analysis—74 (50.7%) participants completed assessments at 3 months, 31 participants (21.2%) completed assessments at 6 months, and 21 participants (14.4%) completed assessments at 9 months. The program included structured lessons and tools (ie, exercises and practices) as well as one-on-one weekly video counseling sessions with a licensed therapist for 12 weeks and monthly check-in sessions for 1 year. The clinically validated Patient Health Questionnaire (PHQ-8) and Generalized Anxiety Disorder Scale (GAD-7) were used to assess depression and anxiety, respectively. Linear mixed-effects modeling was employed to examine changes in depression and anxiety over time. Results We observed a significant positive effect of program time on improvement in depression (β=–0.12, P<.001) and anxiety scores (β=–0.10, P<.001). At the end of the 12-week intervention, we observed an average reduction of 3.76 points (95% CI –4.76 to –2.76) in PHQ-8 scores. Further reductions in depression were seen at program month 6 (4.75-point reduction, 95% CI –6.61 to –2.88) and program month 9 (6.42-point reduction, 95% CI –8.66 to –6.55, P<.001). A similar pattern of improvement emerged for anxiety, with a 3.17-point reduction at the end of the 12-week intervention (95% CI –4.21 to –2.13). These improvements were maintained at program month 6 (4.87-point reduction, 95% CI –6.85 to –2.87) and program month 9 (5.19-point, 95% –6.85 to 4.81). In addition, greater program engagement during the first 12 weeks predicted a greater reduction in depression (β=–0.29, P<.001) Conclusions The results suggest that digital interventions can support sustained and clinically meaningful improvements in depression and anxiety. Furthermore, it appears that strong initial digital mental health intervention engagement may facilitate this effect. However, the study was limited by postintervention participant attrition as well as the retrospective observational study design.

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Section: Discussionmentioning

confidence: 99%

Digital Cognitive Behavior Therapy Intervention for Depression and Anxiety: Retrospective Study

Venkatesan¹,

Rahimi²,

Kaur³

et al. 2020

JMIR Ment Health

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“…A low risk of bias was assessed in fourteen [ 49 , 50 , 51 , 52 , 53 , 55 , 56 , 58 , 59 , 61 , 62 , 64 , 65 , 66 ] of the seventeen articles presented in this work. Only three studies [ 54 , 57 , 60 ] presented some concerns due to deviations from the intended interventions [ 57 ], randomization and allocation process [ 54 ] or missing outcome data [ 60 ]. Overall, results from this analysis showed a methodological solidity for the articles selected adequate to allow drawing meaningful conclusions from further analyses.…”

Section: Resultsmentioning

confidence: 99%

“…Three studies [ 54 , 55 , 57 ] proposed remote psychotherapy treatments including at least one CBT module. These were administered to patients by trained healthcare professionals, via in-home video conferencing [ 55 ] or telephone/mobile [ 54 , 57 ]. Four studies [ 58 , 62 , 64 , 66 ] proposed telemonitoring interventions, with or without standard care.…”

Section: Resultsmentioning

confidence: 99%

“…A detailed summary of the interventions considered is provided in Table S3 : Interventions’ description and design. Fourteen out of the seventeen articles considered, found digital interventions to be effective in reducing depression and anxiety outcomes [ 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 ].…”

Section: Resultsmentioning

confidence: 99%

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Digital Interventions for Psychological Comorbidities in Chronic Diseases—A Systematic Review

Maisto

Diana

Tella

et al. 2021

JPM

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Chronic diseases represent one of the main causes of death worldwide. The integration of digital solutions in clinical interventions is broadly diffused today; however, evidence on their efficacy in addressing psychological comorbidities of chronic diseases is sparse. This systematic review analyzes and synthesizes the evidence about the efficacy of digital interventions on psychological comorbidities outcomes of specific chronic diseases. According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic search of PubMed, PsycInfo, Scopus and Web of Science databases was conducted. Only Randomized Controlled Trials (RCTs) were considered and either depression or anxiety had to be assessed to match the selection criteria. Of the 7636 identified records, 17 matched the inclusion criteria: 9 digital interventions on diabetes, 4 on cardiovascular diseases, 3 on Chronic Obstructive Pulmonary Disease (COPD) and one on stroke. Of the 17 studies reviewed, 14 found digital interventions to be effective. Quantitative synthesis highlighted a moderate and significant overall effect of interventions on depression, while the effect on anxiety was small and non-significant. Design elements making digital interventions effective for psychological comorbidities of chronic diseases were singled out: (a) implementing a communication loop with patients and (b) providing disease-specific digital contents. This focus on “how” to design technologies can facilitate the translation of evidence into practice.

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“…In another clinical trial, we demonstrated that a patient goalsbased approach can significantly improve scores on a validated depression-specific PROM compared with routine guidelines-based care. 33 These findings suggest that individualised approaches to goal attainment can be coupled with PROMs to provide a balanced (individualised goals along with population-level measures) approach to quality measurement of patient-centred care.…”

Section: Measuring Goal Attainment As a Patient-centred Care Quality mentioning

confidence: 94%

Achieving patient priorities: an alternative to patient-reported outcome measures (PROMs) for promoting patient-centred care

Naik

Catic

2020

BMJ Qual Saf

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Effect of Telephone-Delivered Collaborative Goal Setting and Behavioral Activation vs Enhanced Usual Care for Depression Among Adults With Uncontrolled Diabetes

Abstract: This randomized clinical trial compares the effectiveness of telephone-delivered collaborative goal setting and behavioral activation vs enhanced usual care for depression symptoms among US veterans with uncontrolled diabetes.

Cited by 38 publications

References 57 publications

Digital Cognitive Behavior Therapy Intervention for Depression and Anxiety: Retrospective Study

Digital Cognitive Behavior Therapy Intervention for Depression and Anxiety: Retrospective Study

Digital Interventions for Psychological Comorbidities in Chronic Diseases—A Systematic Review

Achieving patient priorities: an alternative to patient-reported outcome measures (PROMs) for promoting patient-centred care

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