Cited by 464Telemedicine and Telehealth ImplementationDigital Mental Health InterventionsMental Health Treatment and Access

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

Hunkeler, E. M.·2000·Archives of Family Medicine

DOI 10.1001/archfami.9.8.700

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Abstract

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.

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Authors: Hunkeler, E. M.
Affiliations: Kaiser Permanente (US)
Corresponding author: Hunkeler, E. M.
Venue: Archives of Family Medicine
Publisher: CLOCKSS Archive
Published: 2000-08-01
Volume: 9
Issue: 8
Pages: 700-708
ISSN: 1063-3987 (ISSN-L)
DOI: 10.1001/archfami.9.8.700
OpenAlex: W1496950002
Cited by: 464
References: 44
Citations by year: 2026: 4 · 2025: 1 · 2024: 3 · 2023: 3 · 2022: 6 · 2021: 2 · 2020: 6 · 2019: 7 · 2018: 6 · 2017: 14 · 2016: 10 · 2015: 13 · 2014: 9 · 2013: 15 · 2012: 8
FWCI: 42.71
Type: journal article
Language: en
Open access: closed
Locations: Archives of Family Medicine (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
Keywords: depression, peer support, primary care, telephone counseling, emotional support, behavioral interventions, treatment satisfaction, psychological functioning, managed care
MeSH terms: Adult, Aged, Antidepressive Agents, Behavior Therapy, California, Combined Modality Therapy, Depressive Disorder, Female, Humans, Male, Managed Care Programs, Middle Aged, Nurses, Primary Health Care, Social Support, Time Factors, Treatment Outcome, Patient Satisfaction, Outcome Assessment, Health Care, Remote Consultation

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

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