The effect of targeted and tailored patient depression engagement interventions on patient-physician discussion of suicidal thoughts: a randomized control trial
Open accessAbstract
Background Despite improvements in the diagnosis and treatment of depression, primary care provider (PCP) discussion regarding suicidal thoughts among patients with depressive symptoms remains low.Objective To determine whether a targeted depression public service announcement (PSA) video or an individually tailored interactive multimedia computer program (IMCP) leads to increased primary care provider (PCP) discussion of suicidal thoughts in patients with elevated risk for clinical depression when compared to an attention control.Design Randomized control trial at five different healthcare systems in Northern California; two academic, two Veterans Affairs (VA), and one group-model health maintenance organization (HMO).Participants Eight-hundred sixty-seven participants, with mean age 51.7; 43.9% women, 43.4% from a racial/ethnic minority group.Intervention The PSA was targeted to gender and socio-economic status, and designed to encourage patients to seek depression care or request information regarding depression. The IMCP was an individually tailored interactive health message designed to activate patients to discuss possible depressive symptoms. The attention control was a sleep hygiene video.Main measures Clinician reported discussion of suicidal thoughts. Analyses were stratified by depressive symptom level (Patient Health Questionnaire [PHQ-9] score < 9 [mild or lower] versus ≥ 10 [at least moderate]).Key results Among patients with a PHQ-9 score ≥ 10, PCP discussion of suicidal thoughts was significantly higher in the IMCP group than in the control group (adjusted odds ratio = 2.33, 95% confidence interval = 1.5, 5.10, p = 0.03). There were no significant effects of either intervention on PCP discussion of suicidal thoughts among patients with a PHQ-9 score < 9.Conclusions Exposure of patients with at least moderate depressive symptoms to an individually tailored intervention designed to increase patient engagement in depression care led to increased PCP discussion of suicidal thoughts.
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Regarding depression, tailored health messages motivate patients to engage in depression care and can help reduce depression severity.
“tailored health messages motivate patients to engage in depression care and can help to reduce depression severity (Levesque et al., 2011; Shah et al., 2014).”
From The efficacy of automated feedback after internet-based depression screening: Study protocol of the German, three-armed, randomised controlled trial DISCOVER (2021) · cites this paper as Shah et al., 2014
The Intervention and Results passages report that a tailored message was designed to engage patients in depression care and increased clinician discussion of suicidal thoughts among patients with at least moderate depressive symptoms. The Measures section identifies discussion—not subsequent depression severity—as the outcome, so the claimed reduction in severity is not supported by this paper. (LLM, conf=0.88)
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“Regarding depression, tailored health messages motivate patients to engage in depression care and can help to reduce depression severity (Levesque et al., 2011; Shah et al., 2014).”
Background
- Authors
- Shah, R., Franks, P., Jerant, A., Feldman, M., Duberstein, P., y Garcia, E. F., Hinton, L., Strohecker, L., & Kravitz, R. L.
- Affiliations
- University of California Davis Medical Center (US)
- University of California, San Francisco (US)
- University of Rochester Medicine (US)
- University of California, Davis (US)
- Sacramento VA Medical Center (US)
- Corresponding author
- Shah, Ruby
- ORCID
- Venue
- Journal of General Internal Medicine
- Published
- 2014-04-08
- Volume
- 29
- Issue
- 8
- Pages
- 1148-1154
- ISSN
- 0884-8734 (ISSN-L)
- 1525-1497
- PMC
- PMC4099444
- OpenAlex
- W1999204861
- Cited by
- 20
- References
- 33
- Citations by year
- 2024: 1 · 2023: 1 · 2022: 2 · 2021: 2 · 2020: 1 · 2019: 1 · 2018: 3 · 2017: 1 · 2016: 3 · 2015: 3 · 2014: 2
- FWCI
- 3.54
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Journal of General Internal Medicine (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institute of Mental Health (R01MH079387)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Keywords
- depression, suicidal ideation, patient engagement, primary care, patient-physician communication, public service announcements, tailored health messages, PHQ-9, depressive symptoms, veterans, health maintenance organizations
- MeSH terms
- Adult, Data Collection, Depressive Disorder, Female, Humans, Male, Middle Aged, Physician-Patient Relations, Primary Health Care, Treatment Outcome, Suicidal Ideation, Early Medical Intervention
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