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技术辅助的糖尿病和/或高血压患者的协作式护理计划在基层医疗保健中的应用:一项可行性研究。

Technology-Assisted Collaborative Care Program for People with Diabetes and/or High Blood Pressure Attending Primary Health Care: A Feasibility Study.

机构信息

Departamento de Psiquiatría y Salud Mental, Hospital Clínico Universidad de Chile, Santiago 8431617, Chile.

Millennium Institute for Depression and Personality Research (MIDAP), Santiago 7820436, Chile.

出版信息

Int J Environ Res Public Health. 2021 Nov 15;18(22):12000. doi: 10.3390/ijerph182212000.

Abstract

The comorbidity of depression with physical chronic diseases is usually not considered in clinical guidelines. This study evaluated the feasibility of a technology-assisted collaborative care (TCC) program for depression in people with diabetes and/or high blood pressure (DM/HBP) attending a primary health care (PHC) facility in Santiago, Chile. Twenty people diagnosed with DM/HBP having a Patient Health Questionnaire-9 score ≥ 15 points were recruited. The TCC program consisted of a face-to-face, computer-assisted psychosocial intervention (CPI, five biweekly sessions), telephone monitoring (TM), and a mobile phone application for behavioral activation (CONEMO). Assessments of depressive symptoms and other health-related outcomes were made. Thirteen patients completed the CAPI, 12 received TM, and none tried CONEMO. The TCC program was potentially efficacious in treating depression, with two-thirds of participants achieving response to depression treatment 12 weeks after baseline. Decreases were observed in depressive symptoms and healthcare visits and increases in mental health-related quality of life and adherence to treatment. Patients perceived the CPI as acceptable. The TCC program was partially feasible and potentially efficacious for managing depression in people with DM/HBP. These data are valuable inputs for a future randomized clinical trial.

摘要

通常情况下,临床指南并未考虑到抑郁与躯体慢性疾病共病的情况。本研究旨在评估一种针对在智利圣地亚哥初级卫生保健机构就诊的糖尿病和/或高血压(DM/HBP)患者的基于技术的协作式护理(TCC)方案治疗抑郁的可行性。共招募了 20 名 DM/HBP 患者,他们的患者健康问卷-9(PHQ-9)评分≥15 分。TCC 方案包括面对面的计算机辅助心理社会干预(CPI,共 5 次双周疗程)、电话监测(TM)和用于行为激活的移动应用程序(CONEMO)。评估抑郁症状和其他与健康相关的结果。13 名患者完成了 CPI,12 名患者接受了 TM,但没有患者尝试 CONEMO。TCC 方案在治疗抑郁方面具有潜在疗效,三分之二的患者在基线后 12 周达到了抑郁治疗的反应。抑郁症状、医疗就诊次数减少,心理健康相关生活质量和治疗依从性增加。患者认为 CPI 可接受。TCC 方案对于管理 DM/HBP 患者的抑郁具有部分可行性和潜在疗效。这些数据为未来的随机临床试验提供了有价值的信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/20dc/8618659/1869820e305d/ijerph-18-12000-g001.jpg

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