Effectiveness of telephone-based aftercare case management for adult patients with unipolar depression compared to usual care: A randomized controlled trial.
- Kivelitz L Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
- Kriston L Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
- Christalle E Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
- Schulz H Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
- Watzke B Clinical Psychology and Psychotherapy Research, Institute of Psychology, University of Zurich, Zurich, Switzerland.
- Härter M Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
- Götzmann L Department of Psychosomatic Medicine and Psychotherapy, Segeberg Hospital, Bad Segeberg, Bad Segeberg, Germany.
- Bailer H Luisenklinik - Zentrum für Verhaltensmedizin, Bad Dürrheim, Germany.
- Zahn S Fachklinik für Psychosomatische Medizin und Psychotherapie, MediClin Seepark Klinik, Bad Bodenteich, Germany.
- Melchior H Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
- 2017-10-28
Published in:
- PloS one. - 2017
Adult
Aftercare
Case Management
Depressive Disorder
Female
Humans
Male
Middle Aged
Prospective Studies
Telephone
Treatment Outcome
English
BACKGROUND
Patients with depression often have limited access to outpatient psychotherapy following inpatient treatment. The objective of the study was to evaluate the long-term effectiveness of a telephone-based aftercare case management (ACM) intervention for patients with depression.
METHODS
We performed a prospective randomized controlled trial in four psychotherapeutic inpatient care units with N = 199 patients with major depression or dysthymia (F32.x, F33.x, F34.1, according to the ICD-10). The ACM consisted of six phone contacts at two-week intervals performed by trained and certified psychotherapists. The control group received usual care (UC). The primary outcome was depressive symptom severity (BDI-II) at 9-month follow-up, and secondary outcomes were health-related quality of life (SF-8, EQ-5D), self-efficacy (SWE), and the proportion of patients initiating outpatient psychotherapy. Mixed model analyses were conducted to compare improvements between treatment groups.
RESULTS
Regarding the primary outcome of symptom severity, the groups did not significantly differ after 3 months (p = .132; ES = -0.23) or at the 9-month follow-up (p = .284; ES = -0.20). No significant differences in health-related quality of life or self-efficacy were found between groups. Patients receiving ACM were more likely to be in outpatient psychotherapy after 3 months (OR: 3.00[1.12-8.07]; p = .029) and 9 months (OR: 4.78 [1.55-14.74]; p = .006) than those receiving UC.
CONCLUSIONS
Although telephone-based ACM did not significantly improve symptom severity, it seems to be a valuable approach for overcoming treatment barriers to the clinical pathways of patients with depression regarding their access to outpatient psychotherapy.
Patients with depression often have limited access to outpatient psychotherapy following inpatient treatment. The objective of the study was to evaluate the long-term effectiveness of a telephone-based aftercare case management (ACM) intervention for patients with depression.
METHODS
We performed a prospective randomized controlled trial in four psychotherapeutic inpatient care units with N = 199 patients with major depression or dysthymia (F32.x, F33.x, F34.1, according to the ICD-10). The ACM consisted of six phone contacts at two-week intervals performed by trained and certified psychotherapists. The control group received usual care (UC). The primary outcome was depressive symptom severity (BDI-II) at 9-month follow-up, and secondary outcomes were health-related quality of life (SF-8, EQ-5D), self-efficacy (SWE), and the proportion of patients initiating outpatient psychotherapy. Mixed model analyses were conducted to compare improvements between treatment groups.
RESULTS
Regarding the primary outcome of symptom severity, the groups did not significantly differ after 3 months (p = .132; ES = -0.23) or at the 9-month follow-up (p = .284; ES = -0.20). No significant differences in health-related quality of life or self-efficacy were found between groups. Patients receiving ACM were more likely to be in outpatient psychotherapy after 3 months (OR: 3.00[1.12-8.07]; p = .029) and 9 months (OR: 4.78 [1.55-14.74]; p = .006) than those receiving UC.
CONCLUSIONS
Although telephone-based ACM did not significantly improve symptom severity, it seems to be a valuable approach for overcoming treatment barriers to the clinical pathways of patients with depression regarding their access to outpatient psychotherapy.
- Language
-
- English
- Open access status
- gold
- Identifiers
-
- DOI 10.1371/journal.pone.0186967
- PMID 29077724
- Persistent URL
- https://sonar.ch/global/documents/47384
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