title: A pilot randomized controlled trial of a depression and disease management program delivered by phone.
abstract: BACKGROUND
  Depression in medically ill patients occurs at twice the rate found in the general population. Though pharmacologic and psychotherapeutic interventions for depression are effective, response to treatment and access to care are barriers for this population. A multidimensional telehealth intervention was designed to focus on these barriers by delivering a phone based intervention that addressed managing one's illness and coping emotionally.
  
  
  METHODS
  Veterans with diabetes, hypertension, or chronic pain and depressive symptoms were randomized to one of three conditions: Usual Care (n=23), Illness Management Only (n=31), or Combined Psychotherapy and Illness Management (n=29). Those randomized to the Combined or Illness Management Only intervention group received 10 phone visits. Veterans in the Combined group received all aspects of the illness management program plus a manualized depression intervention. Subjects completed assessments at baseline, week 5, and 10 to test the main hypothesis that veterans in the Combined condition would have a greater decline in depressive symptoms.
  
  
  RESULTS
  The Combined intervention yielded a significant decline in depressive symptoms when compared with Usual Care. However, the there was no significant difference between the Combined and Illness Management Only groups.
  
  
  CONCLUSIONS
  This is a pilot study with a small sample size relative to a standard randomized controlled trial in psychotherapy.
  
  
  CONCLUSIONS
  This telephone-based intervention succeeded in reducing depressive symptoms in veterans with chronic illness. It adds to the building evidence base for providing phone-delivered mental health services.
authors.affiliation: VA Office of Rural Health, Veterans Rural Health Resource Center-Central Region, Iowa City VAMC, Iowa City, IA and the Comprehensive Access and Delivery Research and Evaluation (CADRE) Center at the Iowa City VA Health Care System, Iowa City, IA, United States; Division of General Internal Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa city, IA, United States.
authors.forename: Arwa
authors.initials: A
authors.lastname: Aburizik
authors.affiliation: Department of Psychiatry, The University of Iowa, Carver College of Medicine, Iowa City, IA, United States.
authors.forename: Lilian
authors.initials: L
authors.lastname: Dindo
authors.affiliation: VA Office of Rural Health, Veterans Rural Health Resource Center-Central Region, Iowa City VAMC, Iowa City, IA and the Comprehensive Access and Delivery Research and Evaluation (CADRE) Center at the Iowa City VA Health Care System, Iowa City, IA, United States.
authors.forename: Peter
authors.initials: P
authors.lastname: Kaboli
authors.affiliation: VA Office of Rural Health, Veterans Rural Health Resource Center-Central Region, Iowa City VAMC, Iowa City, IA and the Comprehensive Access and Delivery Research and Evaluation (CADRE) Center at the Iowa City VA Health Care System, Iowa City, IA, United States; Department of Epidemiology, The University of Iowa College of Public Health, Iowa City, IA, United States.
authors.forename: Mary
authors.initials: M
authors.lastname: Charlton
authors.affiliation: VA Office of Rural Health, Veterans Rural Health Resource Center-Central Region, Iowa City VAMC, Iowa City, IA and the Comprehensive Access and Delivery Research and Evaluation (CADRE) Center at the Iowa City VA Health Care System, Iowa City, IA, United States; Department of Psychiatry, The University of Iowa, Carver College of Medicine, Iowa City, IA, United States.
authors.forename: Klein
authors.initials: K
authors.lastname: Dawn
authors.affiliation: VA Office of Rural Health, Veterans Rural Health Resource Center-Central Region, Iowa City VAMC, Iowa City, IA and the Comprehensive Access and Delivery Research and Evaluation (CADRE) Center at the Iowa City VA Health Care System, Iowa City, IA, United States; Department of Psychiatry, The University of Iowa, Carver College of Medicine, Iowa City, IA, United States. Electronic address: carolyn-turvey@uiowa.edu.
authors.forename: Carolyn
authors.initials: C
authors.lastname: Turvey
mesh_terms: D000368:Aged; D002908:Chronic Disease; D059350:Chronic Pain / Q000150:complications / Q000628:therapy*; D003863:Depression / Q000150:complications / Q000628:therapy*; D003920:Diabetes Mellitus / Q000628:therapy*; D019468:Disease Management; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D017216:Telemedicine; D014728:Veterans / Q000523:psychology
keywords: Chronic illness; Chronic pain; Depression; Diabetes; Hypertension; Telehealth