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Randomized trial of telephone versus in-person delivery of a brief psychosocial intervention in post-stroke depression

BACKGROUND: A psychosocial behavioral intervention delivered in-person by advanced practice nurses has been shown effective in substantially reducing post-stroke depression (PSD). This follow-up trial compared the effectiveness of a shortened intervention delivered by either telephone or in-person t...

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Autores principales: Kirkness, Catherine J., Cain, Kevin C., Becker, Kyra J., Tirschwell, David L., Buzaitis, Ann M., Weisman, Pamela L., McKenzie, Sylvia, Teri, Linda, Kohen, Ruth, Veith, Richard C., Mitchell, Pamela H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5633890/
https://www.ncbi.nlm.nih.gov/pubmed/29017589
http://dx.doi.org/10.1186/s13104-017-2819-y
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author Kirkness, Catherine J.
Cain, Kevin C.
Becker, Kyra J.
Tirschwell, David L.
Buzaitis, Ann M.
Weisman, Pamela L.
McKenzie, Sylvia
Teri, Linda
Kohen, Ruth
Veith, Richard C.
Mitchell, Pamela H.
author_facet Kirkness, Catherine J.
Cain, Kevin C.
Becker, Kyra J.
Tirschwell, David L.
Buzaitis, Ann M.
Weisman, Pamela L.
McKenzie, Sylvia
Teri, Linda
Kohen, Ruth
Veith, Richard C.
Mitchell, Pamela H.
author_sort Kirkness, Catherine J.
collection PubMed
description BACKGROUND: A psychosocial behavioral intervention delivered in-person by advanced practice nurses has been shown effective in substantially reducing post-stroke depression (PSD). This follow-up trial compared the effectiveness of a shortened intervention delivered by either telephone or in-person to usual care. To our knowledge, this is the first of current behavioral therapy trials to expand the protocol in a new clinical sample. 100 people with Geriatric Depression Scores ≥ 11 were randomized within 4 months of stroke to usual care (N = 28), telephone intervention (N = 37), or in-person intervention (N = 35). Primary outcome was response [percent reduction in the Hamilton Depression Rating Scale (HDRS)] and remission (HDRS score < 10) at 8 weeks and 12 months post treatment. RESULTS: Intervention groups were combined for the primary analysis (pre-planned). The mean response in HDRS scores was 39% reduction for the combined intervention group (40% in-person; 38% telephone groups) versus 33% for the usual care group at 8 weeks (p = 0.3). Remission occurred in 37% in the combined intervention groups at 8 weeks versus 27% in the control group (p = 0.3) and 44% intervention versus 36% control at 12 months (p = 0.5). While favouring the intervention, these differences were not statistically significant. CONCLUSIONS: A brief psychosocial intervention for PSD delivered by telephone or in-person did not reduce depression significantly more than usual care. However, the comparable effectiveness of telephone and in-person follow-up for treatment of depression found is important given greater accessibility by telephone and mandated post-hospital follow-up for comprehensive stroke centers. Clinical Trial Registration URL: https://register.clinicaltrials.gov, unique identifier: NCT01133106, Registered 5/26/2010 ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13104-017-2819-y) contains supplementary material, which is available to authorized users.
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spelling pubmed-56338902017-10-19 Randomized trial of telephone versus in-person delivery of a brief psychosocial intervention in post-stroke depression Kirkness, Catherine J. Cain, Kevin C. Becker, Kyra J. Tirschwell, David L. Buzaitis, Ann M. Weisman, Pamela L. McKenzie, Sylvia Teri, Linda Kohen, Ruth Veith, Richard C. Mitchell, Pamela H. BMC Res Notes Research Article BACKGROUND: A psychosocial behavioral intervention delivered in-person by advanced practice nurses has been shown effective in substantially reducing post-stroke depression (PSD). This follow-up trial compared the effectiveness of a shortened intervention delivered by either telephone or in-person to usual care. To our knowledge, this is the first of current behavioral therapy trials to expand the protocol in a new clinical sample. 100 people with Geriatric Depression Scores ≥ 11 were randomized within 4 months of stroke to usual care (N = 28), telephone intervention (N = 37), or in-person intervention (N = 35). Primary outcome was response [percent reduction in the Hamilton Depression Rating Scale (HDRS)] and remission (HDRS score < 10) at 8 weeks and 12 months post treatment. RESULTS: Intervention groups were combined for the primary analysis (pre-planned). The mean response in HDRS scores was 39% reduction for the combined intervention group (40% in-person; 38% telephone groups) versus 33% for the usual care group at 8 weeks (p = 0.3). Remission occurred in 37% in the combined intervention groups at 8 weeks versus 27% in the control group (p = 0.3) and 44% intervention versus 36% control at 12 months (p = 0.5). While favouring the intervention, these differences were not statistically significant. CONCLUSIONS: A brief psychosocial intervention for PSD delivered by telephone or in-person did not reduce depression significantly more than usual care. However, the comparable effectiveness of telephone and in-person follow-up for treatment of depression found is important given greater accessibility by telephone and mandated post-hospital follow-up for comprehensive stroke centers. Clinical Trial Registration URL: https://register.clinicaltrials.gov, unique identifier: NCT01133106, Registered 5/26/2010 ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13104-017-2819-y) contains supplementary material, which is available to authorized users. BioMed Central 2017-10-10 /pmc/articles/PMC5633890/ /pubmed/29017589 http://dx.doi.org/10.1186/s13104-017-2819-y Text en © The Author(s) 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Kirkness, Catherine J.
Cain, Kevin C.
Becker, Kyra J.
Tirschwell, David L.
Buzaitis, Ann M.
Weisman, Pamela L.
McKenzie, Sylvia
Teri, Linda
Kohen, Ruth
Veith, Richard C.
Mitchell, Pamela H.
Randomized trial of telephone versus in-person delivery of a brief psychosocial intervention in post-stroke depression
title Randomized trial of telephone versus in-person delivery of a brief psychosocial intervention in post-stroke depression
title_full Randomized trial of telephone versus in-person delivery of a brief psychosocial intervention in post-stroke depression
title_fullStr Randomized trial of telephone versus in-person delivery of a brief psychosocial intervention in post-stroke depression
title_full_unstemmed Randomized trial of telephone versus in-person delivery of a brief psychosocial intervention in post-stroke depression
title_short Randomized trial of telephone versus in-person delivery of a brief psychosocial intervention in post-stroke depression
title_sort randomized trial of telephone versus in-person delivery of a brief psychosocial intervention in post-stroke depression
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5633890/
https://www.ncbi.nlm.nih.gov/pubmed/29017589
http://dx.doi.org/10.1186/s13104-017-2819-y
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