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Comparative Study
. 2010 Dec 19;12(5):e63.
doi: 10.2196/jmir.1510.

Feasibility of an eHealth service to support collaborative depression care: results of a pilot study

Matic Meglic  1 , Mirjana Furlan, Marja Kuzmanic, Dejan Kozel, Dusan Baraga, Irma Kuhar, Branko Kosir, Rade Iljaz, Brigita Novak Sarotar, Mojca Zvezdana Dernovsek, Andrej Marusic, Gunther Eysenbach, Andrej Brodnik
Affiliations
Comparative Study

Feasibility of an eHealth service to support collaborative depression care: results of a pilot study

Matic Meglic et al. J Med Internet Res. .

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."

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Conflict of interest statement

None declared.

Editorial note: One of the authors (GE) is also editor of the Journal of Medical Internet Research (JMIR). Because of his involvement in the conduct of this research and writing of this paper, assessment and peer review have been carried out entirely by an associate editor (Riper). GE has not been involved in any editorial decisions related to this paper.

Figures

Figure 1
Figure 1
Simplified patient view of the intervention in which arrows describe the direction of information flow, boxes represent ICT system functionalities, and icons above arrows denote available channels (personal computer, mobile phone)
Figure 2
Figure 2
Screenshot of “Improvehealth.eu” in which a patient is submitting a questionnaire (the red semibrackets indicate particular modules, explained in boxes on the right hand side)
Figure 3
Figure 3
Kaplan-Meier survival analysis for use of intervention (dotted vertical line denotes Time 1 at beginning of the 24th week)
See this image and copyright information in PMC

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