[Assessment of a distant collaborative program for the treatment of depression in primary care]

Abstract

Background: In the treatment of depression, primary care teams play an important role, whose effectiveness improves when inserted into a collaborative model of disease management.

Aim: To report the results of a clinical trial carried out to test the effectiveness of a collaborative program between primary health teams and specialists supported by an electronic platform.

Material and methods: Physicians from four community hospitals belonging to the Reloncavi Health Service network, recruited 81 patients with depression aged 37 to 43 years, 84% of whom were female. Participants were divided in an active group, which participated in the collaborative program and a control group, which received the usual care, according to the Ministry of Health'’s Guidelines for Depression. The main outcome was the Beck Depression Inventory (BDI-I) score at three months of intervention.

Results: Participants had an average of 29.6 points (95% CI: 27.6-31.6) in the BDI-I and 38% of them had a high suicide risk. There were no statistically significant baseline differences between active and control group. In the intervention group, the BDI-I score changed from 30.0 (95% CI 27.0 to 32.8) to 15.3 (95% CI 11.8 to 18.8). In the control group the score changed from 29.2 (95% CI: 26.4-31.9) points to 20.8 (95% CI 16.8 to 24.7). The decrease was significantly higher in the intervention groups.

Conclusions: A program of this kind may be useful to assist primary care teams in remote areas of the country to improve treatment outcomes for depression.