Baseline Psychological Treatment Reduces the Effect of Coaching in a Randomised Trial of a Depression Self-Care Intervention.
To explore the effects of baseline psychological and antidepressant medication treatment in a trial of lay telephone coaching in a low-intensity, supported depression self-care intervention.



A single blind, individually randomised, pragmatic trial was conducted among primary care adults with chronic physical conditions and comorbid depressive symptoms. Eligible subjects were randomised to receive a depression self-care toolkit with (intervention group) or without (control group) telephone coaching provided by trained lay coaches. For this brief communication, a secondary analysis of the trial data focused on the effects of baseline psychological and antidepressant treatments on mental health outcomes (Patient Health Questionnaire 9 [PHQ-9], SF-12 Mental Component Summary [MCS], Generalized Anxiety Disorder 7 [GAD-7]) and satisfaction with the intervention.



In total, 223 patients were randomised, and 165 (74.0%) completed both 3- and 6-month follow-ups. There were 2 significant interactions of baseline treatment and study group for 6-month mental health outcomes. A significant benefit of coaching on 6-month PHQ-9 was seen only among participants who were not receiving baseline psychological treatment. A smaller interaction was found for baseline antidepressant medications and 6-month mental health. There was a significant main effect for baseline psychological treatment and lower 6-month satisfaction.



Depressed patients receiving baseline psychological treatment may not benefit from lay coaching offered as part of a low-intensity depression self-care intervention.
1 Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec.|2 St. Mary's Research Centre, Montreal, Quebec.
Jane
J
McCusker
3 Department of Psychiatry, McGill University, Montreal, Quebec.|4 Geriatric Psychiatry Division, St. Mary's Hospital Center, Montreal, Quebec.
Martin
M
Cole
2 St. Mary's Research Centre, Montreal, Quebec.|5 Ingram School of Nursing, McGill University, Montreal, Quebec.
Sylvie
S
Lambert
6 Department of Family Medicine, McGill University, Montreal, Quebec.|7 Family Medicine Centre, St. Mary's Hospital Center, Montreal, Quebec.
Mark
M
Yaffe
1 Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec.|2 St. Mary's Research Centre, Montreal, Quebec.
Antonio
A
Ciampi
2 St. Mary's Research Centre, Montreal, Quebec.
Eric
E
Belzile
D000328:Adult; D000368:Aged; D015897:Comorbidity; D003863:Depression / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010353:Patient Education as Topic / Q000379:methods*; D012648:Self Care / Q000379:methods*; D016037:Single-Blind Method
RCT; depression; lay telephone coaching; primary care; self-care; self-management