Feasibility of an eHealth Service to Support Collaborative Depression Care: Results of a Pilot Study

Abstract

Background Treatments and organizational changes supported by eHealth are beginning to play an important role in improving disease treatment outcome and providing cost-efficient care management. “Improvehealth.eu” is a novel eHealth service to support the treatment of patients with depressive disorder. It offers active patient engagement and collaborative care management by combining Web- and mobile-based information and communication technology systems and access to care managers.Objectives Our objective was to assess the feasibility of a novel eHealth service.Methods The intervention—the “Improvehealth.eu” service—was explored in the course of a pilot study comparing two groups of patients receiving treatment as usual and treatment as usual with eHealth intervention. We compared patients’ medication adherence and outcome measures between both groups and additionally explored usage and overall perceptions of the intervention in intervention group.Results The intervention was successfully implemented in a pilot with 46 patients, of whom 40 were female. Of the 46 patients, 25 received treatment as usual, and 21 received the intervention in addition to treatment as usual. A total of 55% (12/25) of patients in the former group and 45% (10/21) in the latter group finished the 6-month pilot. Available case analysis indicated an improvement of adherence in the intervention group (odds ratio [OR] = 10.0, P = .03). Intention-to-treat analysis indicated an improvement of outcome in the intervention group (ORs ranging from 0.35 to 18; P values ranging from .003 to .20), but confidence intervals were large due to small sample sizes. Average duration of use of the intervention was 107 days. The intervention was well received by 81% (17/21) of patients who reported feeling actively engaged, in control of their disease, and that they had access to a high level of information. In all, 33% (7/21) of the patients also described drawbacks of the intervention, mostly related to usability issues.Conclusions The results of this pilot study indicate that the intervention was well accepted and helped the patients in the course of treatment. The results also suggest the potential of the intervention to improve both medication adherence and outcome measures of treatment, including reduction of depression severity and patients becoming “healthy.”

A Web-Delivered Care Management and Patient Self-Management Program for Recurrent Depression: A Randomized Trial

“…Interventions without the support of a therapist and those with usual-care comparison groups had small effect sizes (.25 and .23, respectively). Other studies show a similar pattern (24)(25)(26)(27)49,50).…”

Evidence-Based Evaluation of eHealth Interventions: Systematic Literature Review

“…However, concerning case studies, all conducted evaluation at the end of the intervention. Although several aspects of evaluation have been found in conceptual articles [32][33][34][35][36][37][38][39]41], the case studies mostly evaluated clinical [20,[42][43][44][46][47][48][49][52][53]55,[59][60][61][64][65], and human/social aspects [42,[46][47][48][49][53][54][55]59,61,63,65].…”

eHealth in integrated care programs for people with multimorbidity in Europe: Insights from the ICARE4EU project

“…Literature shows in particular that when the well-established CCM is expanded as eCCM with the addition of eHealth technologies [35], it can further improve health outcomes for people with chronic conditions, support patient-provider interactions [62,63], and enhance self-management [64,65]. Moreover, given that in specific eHealth education is a crucial issue for self-care, an important expansion of the CCM regards the addition of "eHealth Education", in order to provide consumers/patients with the necessary digital health literacy skills [66].…”