James E. Aikens|Ranak Trivedi|Alicia Heapy|P. Pfeiffer|John D. Piette
Potential Impact of Incorporating a Patient-Selected Support Person into mHealth for Depression
University of Michigan–Ann Arbor|VA Palo Alto Health Care System|Center for Innovation|VA Connecticut Healthcare System|VA Center for Clinical Management Research|VA Center for Clinical Management Research
although telephone care management improves depression outcomes implementation standalone strategy often feasible resourceconstrained settings moreover little research examined potential role selfmanagement support patients trusted confidantsto investigate potential benefits integrating patientselected support person automated mobile health mhealth depressionpatient preference trialdepressed primary care patients risk antidepressant nonadherence ie morisky medication adherence scale total score 1patients received weekly interactive voice response ivr telephone calls depression included selfmanagement guidance could opt designate lay support person outside home receive guidance supporting selfmanagement patients clinicians automatically notified urgent patient issueseach week period 6 months used ivr calls monitor depression patient health questionnaire9 phq9 total 5 classified remission adherence single item reflecting perfect adherence past week functional impairment bed days due mental healthof 221 atrisk patients 61 participated support person analyses adjusted race medical comorbidity baseline levels symptom severity adherence significant interaction effects indicated initial phase program patients participated support person improved significantly likelihood either adhering antidepressant medication aor 131 95 ci 116147 p 0001 achieving remission depression symptoms aor 124 95 ci 114134 p 0001 benefits maintained throughout 6month observation periodincorporating human factor patientselected support person automated mhealth depression selfmanagement may yield sustained improvements antidepressant adherence depression symptom remission however needs confirmed subsequent randomized controlled trial