JAMA & ARCHIVES
Arch Fam Med
SEARCH
GO TO ADVANCED SEARCH
HOME  PAST ISSUES  TOPIC COLLECTIONS  CME  PHYSICIAN JOBS  CONTACT US  HELP
Institution: STANFORD Univ Med Center  | My Account | E-mail Alerts | Access Rights | Sign In
  Vol. 9 No. 8, August 2000 TABLE OF CONTENTS
  Archives
  •  Online Features
  Original Contribution
 This Article
 •Full text
 •PDF
 •Send to a friend
 • Save in My Folder
 •Save to citation manager
 •Permissions
 Citing Articles
 •Citation map
 •Citing articles on HighWire
 •Citing articles on Web of Science (215)
 •Contact me when this article is cited
 Related Content
 •Related articles
 •Similar articles in this journal
 Topic Collections
 •Drug Therapy
 •Adherence
 •Informatics/ Internet in Medicine
 •Telemedicine
 •Nursing Care
 •Treatment Adherence
 •Psychiatry
 •Depression
 •Randomized Controlled Trial
 •Alert me on articles by topic

Efficacy of Nurse Telehealth Care and Peer Support in Augmenting Treatment of Depression in Primary Care

Enid M. Hunkeler, MA; Joel F. Meresman, PhD; William A. Hargreaves, PhD; Bruce Fireman, MS; William H. Berman, PhD; Arlene J. Kirsch, PhD; Jennifer Groebe, LCSW; Stephen W. Hurt, PhD; Patricia Braden; Michael Getzell, MD; Paul A. Feigenbaum, MD; Tiffany Peng, MA; Mark Salzer, PhD

Arch Fam Med. 2000;9:700-708.

Background  Primary care treatment of depression needs improvement.

Objective  To evaluate the efficacy of 2 augmentations to antidepressant drug treatment.

Design  Randomized trial comparing usual care, telehealth care, and telehealth care plus peer support; assessments were conducted at baseline, 6 weeks, and 6 months.

Setting  Two managed care adult primary care clinics.

Participants  A total of 302 patients starting antidepressant drug therapy.

Interventions  For telehealth care: emotional support and focused behavioral interventions in ten 6-minute calls during 4 months by primary care nurses; and for peer support: telephone and in-person supportive contacts by trained health plan members recovered from depression.

Main Outcome Measures  For depression: the Hamilton Depression Rating Scale and the Beck Depression Inventory; and for mental and physical functioning: the SF-12 Mental and Physical Composite Scales and treatment satisfaction.

Results  Nurse-based telehealth patients with or without peer support more often experienced 50% improvement on the Hamilton Depression Rating Scale at 6 weeks (50% vs 37%; P = .01) and 6 months (57% vs 38%; P = .003) and on the Beck Depression Inventory at 6 months (48% vs 37%; P = .05) and greater quantitative reduction in symptom scores on the Hamilton scale at 6 months (10.38 vs 8.12; P = .006). Telehealth care improved mental functioning at 6 weeks (47.07 vs 42.64; P = .004) and treatment satisfaction at 6 weeks (4.41 vs 4.17; P = .004) and 6 months (4.20 vs 3.94; P = .001). Adding peer support to telehealth care did not improve the primary outcomes.

Conclusion  Nurse telehealth care improves clinical outcomes of antidepressant drug treatment and patient satisfaction and fits well within busy primary care settings.


From the Division of Research, Kaiser Permanente Northern California, Oakland (Mss Hunkeler, Groebe, Braden, and Peng, Dr Hargreaves, and Mr Fireman); Departments of Psychiatry (Dr Meresman) and Medicine (Dr Getzell), Kaiser Permanente Northern California, Hayward; Department of Psychiatry, University of California, San Francisco (Dr Hargreaves); Department of Psychology, Fordham University, Bronx, NY (Dr Berman); SmithKline Beecham Pharmaceuticals (Dr Kirsch) and Department of Psychiatry, Weill Medical College of Cornell University, Westchester Division, White Plains, NY (Dr Hurt); and Department of Medicine, Kaiser Permanente Northern California, San Francisco (Dr Feigenbaum).


RELATED ARTICLES

Improvement of Outcomes in Chronic Illness
Wayne Katon
Arch Fam Med. 2000;9(8):709-711.
FULL TEXT  

The Archives of Family Medicine Continuing Medical Education Program
Arch Fam Med. 2000;9(8):735.
FULL TEXT  


THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Wishing Upon a STAR*D: The Promise of Ideal Depression Care by Primary Care Providers
Ong and Rubenstein
Psychiatr. Serv. 2009;60:1460-1462.
ABSTRACT | FULL TEXT  

To screen or not to screen? Depression in patients with cardiovascular disease.
Whooley
J Am Coll Cardiol 2009;54:891-893.
ABSTRACT | FULL TEXT  

Promoting Mental Health Recovery After Hurricanes Katrina and Rita: What Can Be Done at What Cost
Schoenbaum et al.
Arch Gen Psychiatry 2009;66:906-914.
ABSTRACT | FULL TEXT  

Home-Based, Peer-Led Chronic Illness Self-Management Training: Findings From a 1-Year Randomized Controlled Trial
Jerant et al.
Ann Fam Med 2009;7:319-327.
ABSTRACT | FULL TEXT  

Emergency telepsychiatry
Yellowlees et al.
J Telemed Telecare 2008;14:277-281.
ABSTRACT | FULL TEXT  

Screening and case-finding instruments for depression: a meta-analysis
Gilbody et al.
CMAJ 2008;178:997-1003.
ABSTRACT | FULL TEXT  

Care Management for Depression in Primary Care Practice: Findings From the RESPECT-Depression Trial
Nutting et al.
Ann Fam Med 2008;6:30-37.
ABSTRACT | FULL TEXT  

Primary Care After Psychiatric Crisis: A Qualitative Analysis
Griswold et al.
Ann Fam Med 2008;6:38-43.
ABSTRACT | FULL TEXT  

Cost-Effectiveness of Quality Improvement Programs for Patients With Subthreshold Depression or Depressive Disorder
Wells et al.
Psychiatr. Serv. 2007;58:1269-1278.
ABSTRACT | FULL TEXT  

Reducing the Burden of Depression: Building Villages for Coordinated Care
Wells and Miranda
JAMA 2007;298:1451-1452.
FULL TEXT  

Sustainable Impact of a Primary Care Depression Intervention
Lee et al.
J Am Board Fam Med 2007;20:427-433.
ABSTRACT | FULL TEXT  

Home Visiting for Adolescent Mothers: Effects on Parenting, Maternal Life Course, and Primary Care Linkage
Barnet et al.
Ann Fam Med 2007;5:224-232.
ABSTRACT | FULL TEXT  

Screening for depression among patients with multiple sclerosis: two questions may be enough
Mohr et al.
Mult Scler 2007;13:215-219.
ABSTRACT  

Major Depression Symptoms in Primary Care and Psychiatric Care Settings: A Cross-Sectional Analysis
Gaynes et al.
Ann Fam Med 2007;5:126-134.
ABSTRACT | FULL TEXT  

Technology Dependence in Home Care: Impact on Patients and Their Family Caregivers
Winkler et al.
Nutr Clin Pract 2006;21:544-556.
ABSTRACT | FULL TEXT  

Collaborative care for depression in primary care: Making sense of a complex intervention: systematic review and meta-regression
Bower et al.
Br. J. Psychiatry 2006;189:484-493.
ABSTRACT | FULL TEXT  

Collaborative Care for Depression: A Cumulative Meta-analysis and Review of Longer-term Outcomes
Gilbody et al.
Arch Intern Med 2006;166:2314-2321.
ABSTRACT | FULL TEXT  

Depression decision support in primary care: a cluster randomized trial.
Dobscha et al.
ANN INTERN MED 2006;145:477-487.
ABSTRACT | FULL TEXT  

Randomized Trial of a Telephone Care Management Program for Outpatients Starting Antidepressant Treatment
Simon et al.
Psychiatr. Serv. 2006;57:1441-1445.
ABSTRACT | FULL TEXT  

A Taxonomy for Disease Management: A Scientific Statement From the American Heart Association Disease Management Taxonomy Writing Group
Krumholz et al.
Circulation 2006;114:1432-1445.
ABSTRACT | FULL TEXT  

Long-term Effectiveness and Cost of a Systematic Care Program for Bipolar Disorder.
Simon et al.
Arch Gen Psychiatry 2006;63:500-508.
ABSTRACT | FULL TEXT  

What is necessary to transform the quality of mental health care.
Patel et al.
Health Aff (Millwood) 2006;25:681-693.
ABSTRACT | FULL TEXT  

Treatment of depression for patients with multiple sclerosis in neurology clinics
Mohr et al.
Mult Scler 2006;12:204-208.
ABSTRACT  

Collaborative care for depression
Simon
BMJ 2006;332:249-250.
FULL TEXT  

Long term outcomes from the IMPACT randomised trial for depressed elderly patients in primary care
Hunkeler et al.
BMJ 2006;332:259-263.
ABSTRACT | FULL TEXT  

Implementation and Maintenance of Quality Improvement for Treating Depression in Primary Care
Meredith et al.
Psychiatr. Serv. 2006;57:48-55.
ABSTRACT | FULL TEXT  

Evaluation of Outcomes With Citalopram for Depression Using Measurement-Based Care in STAR*D: Implications for Clinical Practice
Trivedi et al.
Am. J. Psychiatry 2006;163:28-40.
ABSTRACT | FULL TEXT  

Suicide Risk During Antidepressant Treatment
Simon et al.
Am. J. Psychiatry 2006;163:41-47.
ABSTRACT | FULL TEXT  

Effect of Improved Primary Care Access on Quality of Depression Care
Solberg et al.
Ann Fam Med 2006;4:69-74.
ABSTRACT | FULL TEXT  

Follow-Up and Follow-Through of Depressed Patients in Primary Care: The Critical Missing Components of Quality Care
Solberg et al.
J Am Board Fam Med 2005;18:520-527.
ABSTRACT | FULL TEXT  

Improving Detection of Suicidal Ideation Among Depressed Patients in Primary Care
Nutting et al.
Ann Fam Med 2005;3:529-536.
ABSTRACT | FULL TEXT  

Economic Grand Rounds: Improving the Quality of Depression Care in Medicaid
Barry and Thomas
Psychiatr. Serv. 2005;56:1193-1195.
FULL TEXT  

The Effect of a Telephone Counseling Intervention on Self-Rated Health of Cardiac Patients
Bambauer et al.
Psychosom. Med. 2005;67:539-545.
ABSTRACT | FULL TEXT  

Quality Improvement for Depression in Primary Care: Do Patients With Subthreshold Depression Benefit in the Long Run?
Wells et al.
Am. J. Psychiatry 2005;162:1149-1157.
ABSTRACT | FULL TEXT  

NICE, but will they help people with depression? The new National Institute for Clinical Excellence depression guidelines
Whitty and Gilbody
Br. J. Psychiatry 2005;186:177-178.
FULL TEXT  

Cost-Effectiveness of Enhancing Primary Care Depression Management on an Ongoing Basis
Rost et al.
Ann Fam Med 2005;3:7-14.
ABSTRACT | FULL TEXT  

Depression and Comorbid Illness in Elderly Primary Care Patients: Impact on Multiple Domains of Health Status and Well-being
Noel et al.
Ann Fam Med 2004;2:555-562.
ABSTRACT | FULL TEXT  

Re-engineering systems for the treatment of depression in primary care: cluster randomised controlled trial
Dietrich et al.
BMJ 2004;329:602.
ABSTRACT | FULL TEXT  

Telephone Psychotherapy and Telephone Care Management for Primary Care Patients Starting Antidepressant Treatment: A Randomized Controlled Trial
Simon et al.
JAMA 2004;292:935-942.
ABSTRACT | FULL TEXT  

Websites offering information about depression or cognitive behaviour therapy reduced depressive symptoms
Simon
Evid. Based Med. 2004;9:116-116.
FULL TEXT  

Going to Scale: Re-Engineering Systems for Primary Care Treatment of Depression
Dietrich et al.
Ann Fam Med 2004;2:301-304.
ABSTRACT | FULL TEXT  

Clinical Results for Patients With Major Depressive Disorder in the Texas Medication Algorithm Project
Trivedi et al.
Arch Gen Psychiatry 2004;61:669-680.
ABSTRACT | FULL TEXT  

The Effectiveness of Depression Care Management on Diabetes-Related Outcomes in Older Patients
Williams et al.
ANN INTERN MED 2004;140:1015-1024.
ABSTRACT | FULL TEXT  

Bridging Community Intervention and Mental Health Services Research
Wells et al.
Am. J. Psychiatry 2004;161:955-963.
ABSTRACT | FULL TEXT  

The Partners in Care Approach to Ethics Outcomes in Quality Improvement Programs for Depression
Halpern et al.
Psychiatr. Serv. 2004;55:532-539.
ABSTRACT | FULL TEXT  

Quality of Care for Medicaid-Covered Youth Treated With Antidepressant Therapy
Richardson et al.
Arch Gen Psychiatry 2004;61:475-480.
ABSTRACT | FULL TEXT  

Five-Year Impact of Quality Improvement for Depression: Results of a Group-Level Randomized Controlled Trial
Wells et al.
Arch Gen Psychiatry 2004;61:378-386.
ABSTRACT | FULL TEXT  

Effectiveness of Disease Management Programs in Depression: A Systematic Review
Badamgarav et al.
Am. J. Psychiatry 2003;160:2080-2090.
ABSTRACT | FULL TEXT  

Disease Management for Depression and At-Risk Drinking Via Telephone in an Older Population of Veterans
Oslin et al.
Psychosom. Med. 2003;65:931-937.
ABSTRACT | FULL TEXT  

Effect on Disability Outcomes of a Depression Relapse Prevention Program
Von Korff et al.
Psychosom. Med. 2003;65:938-943.
ABSTRACT | FULL TEXT  

Treating Depression in Predominantly Low-Income Young Minority Women: A Randomized Controlled Trial
Miranda et al.
JAMA 2003;290:57-65.
ABSTRACT | FULL TEXT  

Educational and Organizational Interventions to Improve the Management of Depression in Primary Care: A Systematic Review
Gilbody et al.
JAMA 2003;289:3145-3151.
ABSTRACT | FULL TEXT  

Aligning Incentives in the Treatment of Depression in Primary Care With Evidence-Based Practice
Frank et al.
Psychiatr. Serv. 2003;54:682-687.
ABSTRACT | FULL TEXT  

Improving the detection and management of depression in primary care
Gilbody et al.
Qual Saf Health Care 2003;12:149-155.
ABSTRACT | FULL TEXT  

Willingness to Pay for Depression Treatment in Primary Care
Unutzer et al.
Psychiatr. Serv. 2003;54:340-345.
ABSTRACT | FULL TEXT  

Application of a Depression Management Office System in Community Practice: A Demonstration
Dietrich et al.
J Am Board Fam Med 2003;16:107-114.
ABSTRACT | FULL TEXT  

Collaborative Care Management of Late-Life Depression in the Primary Care Setting: A Randomized Controlled Trial
Unutzer et al.
JAMA 2002;288:2836-2845.
ABSTRACT | FULL TEXT  

A Three-Component Model for Reengineering Systems for the Treatment of Depression in Primary Care
Oxman et al.
Psychosomatics 2002;43:441-450.
ABSTRACT | FULL TEXT  

Interventions used in disease management programmes for patients with chronic illness---which ones work? Meta-analysis of published reports
Weingarten et al.
BMJ 2002;325:925-925.
ABSTRACT | FULL TEXT  

Managing depression as a chronic disease: a randomised trial of ongoing treatment in primary care
Rost et al.
BMJ 2002;325:934-934.
ABSTRACT | FULL TEXT  

Is This Patient Clinically Depressed?
Williams et al.
JAMA 2002;287:1160-1170.
ABSTRACT | FULL TEXT  

Cost-effectiveness of Practice-Initiated Quality Improvement for Depression: Results of a Randomized Controlled Trial
Schoenbaum et al.
JAMA 2001;286:1325-1330.
ABSTRACT | FULL TEXT  

A Randomized Effectiveness Trial of Collaborative Care for Patients With Panic Disorder in Primary Care
Roy-Byrne et al.
Arch Gen Psychiatry 2001;58:869-876.
ABSTRACT | FULL TEXT  

Nurse telehealth care reduced depressive symptoms and improved functioningCommentary
LeGris
Evid. Based Ment. Health 2001;4:49-49.
FULL TEXT  

Adjunctive nurse telehealth care reduced depressive symptoms and improved functioning
LeGris
Evid. Based Nurs. 2001;4:50-50.
FULL TEXT  

Treatment Process and Outcomes for Managed Care Patients Receiving New Antidepressant Prescriptions From Psychiatrists and Primary Care Physicians
Simon et al.
Arch Gen Psychiatry 2001;58:395-401.
ABSTRACT | FULL TEXT  

Managing Depression in Medical Outpatients
Whooley and Simon
NEJM 2000;343:1942-1950.
FULL TEXT  

Can Depression Treatment in Primary Care Reduce Disability?: A Stepped Care Approach
Lin et al.
Arch Fam Med 2000;9:1052-1058.
ABSTRACT | FULL TEXT  

Improvement of Outcomes in Chronic Illness
Katon
Arch Fam Med 2000;9:709-711.
FULL TEXT  




HOME | CURRENT ISSUE | PAST ISSUES | TOPIC COLLECTIONS | CME | PHYSICIAN JOBS | HELP
CONDITIONS OF USE | PRIVACY POLICY | CONTACT US | SITE MAP
 
© 2000 American Medical Association. All Rights Reserved.