Positive impact of a family practice-based depression case management on patient's self-management

Abstract

Objective: Family practice-based depression case management improves depression symptoms and adherence to medication. The aim of this study was to explore the long-term effects of practice-based depression case management on patient depression-related self-management knowledge and activities.

Methods: This long-term follow-up of a randomized controlled trial study took place 12 months after the end of the 1-year case management intervention. We used a modified version of the depression-specific self-management questionnaire described in Ludman et al. [Psychol Med, 33 (2003) 1061-1070]. Analyses of self-management knowledge and activities used a linear mixed model accounting for practice cluster effects and treatment group.

Results: Of the 626 patients included at baseline, 439 (70.1%) participated 24 months later in this follow-up study, i.e., 12 months after the end of the intervention. Compared to control recipients, intervention recipients presented statistically significant increased knowledge of medication side-effects and felt more able to avoid situations that may trigger depression. They also tried more often to undertake enjoyable activities and set more time aside for these activities.

Conclusion: This study suggests that case management improves depression-related self-management knowledge and activities in depressed primary care patients 12 months after the end of the intervention.

Practice implications: Clinicians may consider introducing practice-based case management for improving patients' self-management activities and knowledge.