Primary Care Prevention and Health Promotion Research Network, RedIAPP, Carlos III Health Institute, Madrid, Spain.
Aragon Institute for Health Research, IIS Aragon, Zaragoza, Spain.
BMC Psychiatry. 2019 Feb 11;19(1):66. doi: 10.1186/s12888-019-2037-3.
The World Health Organization (WHO) has included comorbidity between depression and a chronic disease among the 10 leading global health priorities. Although there is a high prevalence of multimorbidity, health care systems are mainly designed for the management of individual diseases. Given the difficulty in delivering face-to-face psychological treatments, alternative models of treatment delivery have been proposed, emphasizing the role of technologies such as the Internet. The aim of this study is to assess the efficacy in Primary Care (PC) of a blended low-intensity psychological intervention applied using information and communication technologies (ICTs) for the treatment of multimorbidity in PC (depression and type 2 diabetes/low back pain) by means of a randomized controlled trial (RCT). Our main hypothesis is that improved usual care combined with psychological therapy applied using ICTs will be more efficacious for improvement in the symptomatology of multimorbidity, compared to a group with only improved treatment as usual six months after the end of treatment.
A protocol has been designed combining a face-to-face intervention with a supporting online programme that will be tested by an RCT conducted in three different regions (Andalusia, Aragon and the Balearic Islands). The RCT will evaluate three hundred participants diagnosed with depression and type 2 diabetes/low back pain. Four highly experienced research groups specializing in clinical psychology are involved in this trial, and there will be ample possibilities for translation and transfer to usual clinical practice.
This clinical trial will lead to improvement in financial sustainability, maximizing the use of resources and responding to principles of efficiency and effectiveness. Furthermore, based on the evaluation of the feasibility of implementing this intervention in primary care facilities, we expect to be able to suggest the intervention for incorporation into public policy. In conclusion, positive results of this study could have a significant impact on one of the most important health-related problems, multimorbidity.
ClinicalTrials.gov, NCT03426709 . Registered retrospectively on 08 February 2018.
世界卫生组织（WHO）将抑郁症与慢性病共病列为全球 10 项主要卫生重点工作之一。尽管共病的发病率很高，但卫生保健系统主要是为管理单一疾病而设计的。鉴于面对面心理治疗的实施困难，已经提出了替代治疗方法，强调了互联网等技术的作用。本研究的目的是通过随机对照试验（RCT）评估在初级保健（PC）中使用信息和通信技术（ICT）实施的混合低强度心理干预对 PC 中多种疾病（抑郁症和 2 型糖尿病/下腰痛）的疗效。我们的主要假设是，与仅改善常规治疗的组相比，在治疗结束后六个月，将改善的常规护理与使用 ICT 实施的心理治疗相结合，将更有效地改善多种疾病的症状。
设计了一种方案，将面对面干预与支持在线计划相结合，将通过在三个不同地区（安达卢西亚、阿拉贡和巴利阿里群岛）进行的 RCT 进行测试。RCT 将评估 300 名被诊断患有抑郁症和 2 型糖尿病/下腰痛的患者。四个专门从事临床心理学的经验丰富的研究小组参与了这项试验，并且有充分的机会将其转化并转移到常规临床实践中。
这项临床试验将提高财务可持续性，最大限度地利用资源，并符合效率和效果原则。此外，根据在初级保健机构实施这种干预的可行性评估，我们期望能够提出将其纳入公共政策的建议。总之，如果这项研究的结果为阳性，可能会对最重要的健康相关问题之一，即多种疾病产生重大影响。
ClinicalTrials.gov，NCT03426709。于 2018 年 2 月 8 日回顾性注册。
