title: Feasibility of an eHealth service to support collaborative depression care: results of a pilot study.
abstract: BACKGROUND
  Treatments and organizational changes supported by eHealth are beginning to play an important role in improving disease treatment outcome and providing cost-efficient care management. "Improvehealth.eu" is a novel eHealth service to support the treatment of patients with depressive disorder. It offers active patient engagement and collaborative care management by combining Web- and mobile-based information and communication technology systems and access to care managers.
  
  
  OBJECTIVE
  Our objective was to assess the feasibility of a novel eHealth service.
  
  
  METHODS
  The intervention--the "Improvehealth.eu" service--was explored in the course of a pilot study comparing two groups of patients receiving treatment as usual and treatment as usual with eHealth intervention. We compared patients' medication adherence and outcome measures between both groups and additionally explored usage and overall perceptions of the intervention in intervention group.
  
  
  RESULTS
  The intervention was successfully implemented in a pilot with 46 patients, of whom 40 were female. Of the 46 patients, 25 received treatment as usual, and 21 received the intervention in addition to treatment as usual. A total of 55% (12/25) of patients in the former group and 45% (10/21) in the latter group finished the 6-month pilot. Available case analysis indicated an improvement of adherence in the intervention group (odds ratio [OR] = 10.0, P = .03). Intention-to-treat analysis indicated an improvement of outcome in the intervention group (ORs ranging from 0.35 to 18; P values ranging from .003 to .20), but confidence intervals were large due to small sample sizes. Average duration of use of the intervention was 107 days. The intervention was well received by 81% (17/21) of patients who reported feeling actively engaged, in control of their disease, and that they had access to a high level of information. In all, 33% (7/21) of the patients also described drawbacks of the intervention, mostly related to usability issues.
  
  
  CONCLUSIONS
  The results of this pilot study indicate that the intervention was well accepted and helped the patients in the course of treatment. The results also suggest the potential of the intervention to improve both medication adherence and outcome measures of treatment, including reduction of depression severity and patients becoming "healthy."
authors.affiliation: Primorska Institute of Nature Science and Technology, University of Primorska, Koper, Slovenia. matic.meglic@upr.si
authors.forename: Matic
authors.initials: M
authors.lastname: Meglic
authors.forename: Mirjana
authors.initials: M
authors.lastname: Furlan
authors.forename: Marja
authors.initials: M
authors.lastname: Kuzmanic
authors.forename: Dejan
authors.initials: D
authors.lastname: Kozel
authors.forename: Dusan
authors.initials: D
authors.lastname: Baraga
authors.forename: Irma
authors.initials: I
authors.lastname: Kuhar
authors.forename: Branko
authors.initials: B
authors.lastname: Kosir
authors.forename: Rade
authors.initials: R
authors.lastname: Iljaz
authors.forename: Brigita
authors.initials: B
authors.lastname: Novak Sarotar
authors.forename: Mojca Zvezdana
authors.initials: MZ
authors.lastname: Dernovsek
authors.forename: Andrej
authors.initials: A
authors.lastname: Marusic
authors.forename: Gunther
authors.initials: G
authors.lastname: Eysenbach
authors.forename: Andrej
authors.initials: A
authors.lastname: Brodnik
mesh_terms: D000328:Adult; D003131:Combined Modality Therapy; D003863:Depression / Q000628:therapy*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D020407:Internet / Q000706:statistics & numerical data*; D008297:Male; D008605:Mental Health Services / Q000458:organization & administration*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D010349:Patient Compliance / Q000706:statistics & numerical data; D010353:Patient Education as Topic / Q000379:methods*; D010358:Patient Participation / Q000706:statistics & numerical data*; D010865:Pilot Projects; D011570:Psychiatry / Q000592:standards; D016896:Treatment Outcome