TY - JOUR
T1 - Feasibility, effectiveness and safety of the self-management intervention deprexis in routine medical care: Results of an uncontrolled observational study
AU - Klein, Jan Philipp
AU - Barthel, Bettina
AU - Berger, Thomas
AU - Moritz, Steffen
N1 - Funding Information:
Data management and statistics: Elmar Beck, ANFOMED GmbH, M?hrendorf, Germany. Individual participant data that underlie the results reported in this article can be shared with researchers who provide a methodologically sound proposal to JPK. Proposals may be submitted up to 36 months following article publication.
Publisher Copyright:
© 2020 The Authors
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/12
Y1 - 2020/12
N2 - Introduction: Numerous RCTs have demonstrated the effectiveness of internet-based self-management interventions (SMIs) in the treatment of depressive symptoms. These studíes often recruit outside routine clinical practice. For the present study, we investigated the feasibility, effectiveness and safety of an SMI (deprexis) in routine medical care using a non-interventional design. Methods: A total of 104 patients with a depressive disorder (60.58% female, mean age 45.82 yrs) were recruited in 25 outpatient practices in Germany (mostly psychiatric practices, n = 16). They received 12 week access to the SMI in addition to their usual care (76.0% took concomitant antidepressant medication). Guidance could optionally be offered by the treating physician. The effectiveness of the intervention was assessed using the clinician-rated short version of the Montgomery Asberg-Depression Scale (svMADRS) and the Patient Health Questionnaire (PHQ-9), a self-rating for depressive symptoms. Outcomes were assessed at baseline as well as at weeks 3, 6, 9 and 12. Results: Most patients reported using the intervention at least once (n = 87, 83.6%), among these users the mean number of sessions was 18.05 (SD = 11.33). Only a minority of patients received the guided version of the intervention (n = 7, 8.0%). The severity of depressive symptoms decreased significantly over the observation period from 29.72 (SD = 10.03) to 15.73 (SD = 9.74) for the svMADRS (Cohen's d = 1.42, 95% CI 0.08–2.76) and from 15.20 (SD = 5.03) to 8.77 (SD = 5.03) for the PHQ-9 (d = 1.29, 95% CI 0.60–1.97). Discussion: The size of the pre-post effect on depressive symptoms observed in this study is comparable to the pre-post effect size reported in an RCT using the same intervention in patients suffering from depressive symptoms of the same severity. Limitations of this study include the lack of a control group and the fact that the recruitment rate was far lower than expected. Conclusion: This non-interventional study conducted in outpatient practices confirms results from numerous RCTs. Taken together, these data show that deprexis can be used effectively and safely in the routine care of depressed outpatients.
AB - Introduction: Numerous RCTs have demonstrated the effectiveness of internet-based self-management interventions (SMIs) in the treatment of depressive symptoms. These studíes often recruit outside routine clinical practice. For the present study, we investigated the feasibility, effectiveness and safety of an SMI (deprexis) in routine medical care using a non-interventional design. Methods: A total of 104 patients with a depressive disorder (60.58% female, mean age 45.82 yrs) were recruited in 25 outpatient practices in Germany (mostly psychiatric practices, n = 16). They received 12 week access to the SMI in addition to their usual care (76.0% took concomitant antidepressant medication). Guidance could optionally be offered by the treating physician. The effectiveness of the intervention was assessed using the clinician-rated short version of the Montgomery Asberg-Depression Scale (svMADRS) and the Patient Health Questionnaire (PHQ-9), a self-rating for depressive symptoms. Outcomes were assessed at baseline as well as at weeks 3, 6, 9 and 12. Results: Most patients reported using the intervention at least once (n = 87, 83.6%), among these users the mean number of sessions was 18.05 (SD = 11.33). Only a minority of patients received the guided version of the intervention (n = 7, 8.0%). The severity of depressive symptoms decreased significantly over the observation period from 29.72 (SD = 10.03) to 15.73 (SD = 9.74) for the svMADRS (Cohen's d = 1.42, 95% CI 0.08–2.76) and from 15.20 (SD = 5.03) to 8.77 (SD = 5.03) for the PHQ-9 (d = 1.29, 95% CI 0.60–1.97). Discussion: The size of the pre-post effect on depressive symptoms observed in this study is comparable to the pre-post effect size reported in an RCT using the same intervention in patients suffering from depressive symptoms of the same severity. Limitations of this study include the lack of a control group and the fact that the recruitment rate was far lower than expected. Conclusion: This non-interventional study conducted in outpatient practices confirms results from numerous RCTs. Taken together, these data show that deprexis can be used effectively and safely in the routine care of depressed outpatients.
UR - http://www.scopus.com/inward/record.url?scp=85090974260&partnerID=8YFLogxK
UR - https://www.mendeley.com/catalogue/fda0c620-65ef-374f-be28-66b3d855665d/
U2 - 10.1016/j.invent.2020.100341
DO - 10.1016/j.invent.2020.100341
M3 - Journal articles
C2 - 32874927
AN - SCOPUS:85090974260
SN - 2214-7829
VL - 22
SP - 100341
JO - Internet Interventions
JF - Internet Interventions
M1 - 100341
ER -