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A collaborative, computer-assisted, psychoeducational intervention for depressed patients with chronic disease at primary care: protocol for a cluster-randomized controlled trial

Published online by Cambridge University Press:  01 September 2022

G. Rojas*
Affiliation:
Hospital Clínico Universidad de Chile, Departamento De Psiquiatría Y Salud Mental, Santiago, Chile
P.A. Martinez Diaz
Affiliation:
Université de Sherbrooke, Faculté De Médecine Et Des Sciences De La Santé, Longueuil, Canada Centre de recherche Charles-Le Moyne sur les innovations en santé, -, Longueuil, Canada
V. Guajardo
Affiliation:
Hospital Clínico Universidad de Chile, Departamento De Psiquiatría Y Salud Mental, Santiago, Chile
S. Campos
Affiliation:
Pontificia Universidad Católica de Chile, Nursing School, Santiago, Chile
P. Herrera
Affiliation:
Universidad de Chile, Facultad De Ciencias Sociales, Santiago, Chile
P. Vöhringer
Affiliation:
Hospital Clínico Universidad de Chile, Departamento De Psiquiatría Y Salud Mental, Santiago, Chile
V. Gomez
Affiliation:
Hospital Clínico Universidad de Chile, Departamento De Psiquiatría Y Salud Mental, Santiago, Chile
W. Szabo
Affiliation:
Hospital Clínico Universidad de Chile, Departamento De Psiquiatría Y Salud Mental, Santiago, Chile
R. Araya
Affiliation:
King’s College London, Centre For Global Mental Health, London, United Kingdom
*
*Corresponding author.

Abstract

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Introduction

Depression treatment recommendations seldom include chronic illness comorbidity.

Objectives

To describe the rationale and methods for a cluster-randomized trial (CRT) in primary care clinics (PCC) comparing a computer-assisted psychoeducational (CAPE) intervention to usual care (UC) for depressed patients with hypertension or diabetes.

Methods

Two-arm, single-blind CRT in Santiago, Chile. Eight PCC will be randomly assigned to the intervention or UC. A total of 360 depressed individuals aged 18 or older PHQ-9 scores ≥ 15 and hypertension or diabetes will be recruited. Patients with alcohol/substance abuse; current treatment for depression, bipolar disorder, or psychosis; illiteracy; severe impairment; and residents in long-term care facilities will be excluded. Patients in the intervention will receive eight CAPE sessions by trained therapists, structured telephone calls to track progress, and usual medical care for chronic diseases. Psychologists and psychiatrists will regularly supervise therapists. To ensure continuity of care, the PCC team will meet monthly with a research team member. Patients in UC will receive standard medical and depression treatment. Three, six, and twelve months after enrollment, outcomes will be assessed. The primary outcome will be a 50% reduction in baseline PHQ-9 scores at six months. Intention-to-treat analyses will be used.

Results

A previous, small-scale pilot study provided valuable insights for study design.

Conclusions

This study will provide first-hand evidence on the effectiveness of a CAPE for depressed patients with chronic diseases at PCC in a Latin American country.

Disclosure

No significant relationships.

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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