Study: Online messaging assuages depression
Online messaging can deliver organized follow-up care for depression effectively and efficiently, according to a randomized controlled trial by Group Health Cooperative, a Seattle-based nonprofit healthcare system, published online this month in the Journal of General Internal Medicine.
Gregory E. Simon, MD, MPH, a Group Health psychiatrist and Group Health Research Institute senior investigator, and colleagues sought to evaluate the feasibility, acceptability and effectiveness of a depression care management program delivered by online messaging through an EMR. The researchers compared usual primary care treatment to primary care supported by online care management with 208 participants across nine primary care clinics in the state of Washington.
After five months, compared with the half of the patients randomly assigned to receive usual care, the half who had three online care management contacts with a trained psychiatric nurse were significantly more likely to feel less depressed, to take their antidepressant medication as prescribed (81 percent continued treatment more than three months vs. 61 percent), and be "very satisfied" with their treatment for depression (53 percent “very satisfied” vs. 33 percent), the study found. The patients in the trial were starting antidepressant medication that their primary care providers prescribed.
In previous studies, Simon and colleagues delivered organized care for depression via telephone calls. Organized depression care includes systematic contact with patients, assessment of their depression and whether they are taking their antidepressant medication as prescribed, and guidelines for evidence-based care. One such guideline is suggesting that the primary care provider change the dose, or add or switch to another medication, if depression or side effects bother a patient after a standard trial period.
For each phone contact with a patient, clinicians wasted a half hour playing "phone tag," Simon said. According to the authors, unlike phone calls, online messages require no simultaneous live contact, so they may boost the convenience and affordability of follow-up care. Simon and colleagues found that secure, asynchronous messages within Group Health's existing EMR can improve care of chronic conditions, and that patients being treated for depression are particularly likely to use online communication with their healthcare providers.
"We worried that patients might need live voice contact in real time to be understood and feel supported," the researchers concluded. "But this online care management helped these patients, even though they never met the trained psychiatric nurse in person or talked with her on the phone."
Gregory E. Simon, MD, MPH, a Group Health psychiatrist and Group Health Research Institute senior investigator, and colleagues sought to evaluate the feasibility, acceptability and effectiveness of a depression care management program delivered by online messaging through an EMR. The researchers compared usual primary care treatment to primary care supported by online care management with 208 participants across nine primary care clinics in the state of Washington.
After five months, compared with the half of the patients randomly assigned to receive usual care, the half who had three online care management contacts with a trained psychiatric nurse were significantly more likely to feel less depressed, to take their antidepressant medication as prescribed (81 percent continued treatment more than three months vs. 61 percent), and be "very satisfied" with their treatment for depression (53 percent “very satisfied” vs. 33 percent), the study found. The patients in the trial were starting antidepressant medication that their primary care providers prescribed.
In previous studies, Simon and colleagues delivered organized care for depression via telephone calls. Organized depression care includes systematic contact with patients, assessment of their depression and whether they are taking their antidepressant medication as prescribed, and guidelines for evidence-based care. One such guideline is suggesting that the primary care provider change the dose, or add or switch to another medication, if depression or side effects bother a patient after a standard trial period.
For each phone contact with a patient, clinicians wasted a half hour playing "phone tag," Simon said. According to the authors, unlike phone calls, online messages require no simultaneous live contact, so they may boost the convenience and affordability of follow-up care. Simon and colleagues found that secure, asynchronous messages within Group Health's existing EMR can improve care of chronic conditions, and that patients being treated for depression are particularly likely to use online communication with their healthcare providers.
"We worried that patients might need live voice contact in real time to be understood and feel supported," the researchers concluded. "But this online care management helped these patients, even though they never met the trained psychiatric nurse in person or talked with her on the phone."