title: Interactive Voice Response-An Innovative Approach to Post-Stroke Depression Self-Management Support.
abstract: Automated interactive voice response (IVR) call systems can provide systematic monitoring and self-management support to depressed patients, but it is unknown if stroke patients are able and willing to engage in IVR interactions. We sought to assess the feasibility and acceptability of IVR as an adjunct to post-stroke depression follow-up care. The CarePartner program is a mobile health program designed to optimize depression self-management, facilitate social support from a caregiver, and strengthen connections between stroke survivors and primary care providers (PCPs). Ischemic stroke patients and an informal caregiver, if available, were recruited during the patient's acute stroke hospitalization or follow-up appointment. The CarePartner program was activated in patients with depressive symptoms during their stroke hospitalization or follow-up. The 3-month intervention consisted of weekly IVR calls monitoring both depressive symptoms and medication adherence along with tailored suggestions for depressive symptom self-management. After each completed IVR call, informal caregivers were automatically updated, and, if needed, the subject's PCP was notified. Of the 56 stroke patients who enrolled, depressive symptoms were identified in 13 (23 %) subjects. Subjects completed 74 % of the weekly IVR assessments. A total of six subjects did not complete the outcome assessment, including two non-study-related deaths. PCPs were notified five times, including two times for suicidal ideation and three times for medication non-adherence. Stroke patients with depressive symptoms were able to engage in an IVR call system. Future studies are needed to explore the efficacy of an IVR approach for post-stroke self-management and monitoring of stroke-related outcomes.
authors.affiliation: Department of Neurology, Stroke Program, University of Michigan, Ann Arbor, MI, USA. lerusche@umich.edu.|University of Michigan Medical Center, 1500 East Medical Center Drive SPC#5855, Ann Arbor, MI, 48109-5855, USA. lerusche@umich.edu.
authors.forename: Lesli E
authors.initials: LE
authors.lastname: Skolarus
authors.affiliation: Ann Arbor Department of Veterans Affairs Center for Clinical Management Research, Ann Arbor, MI, USA.|School of Public Health, University of Michigan, Ann Arbor, MI, USA.|School of Medicine, University of Michigan, Ann Arbor, MI, USA.
authors.forename: John D
authors.initials: JD
authors.lastname: Piette
authors.affiliation: Psychiatry, University of Michigan, Ann Arbor, MI, USA.|VA HSR&D Center for Health Information and Communication, Indianapolis, IN, USA.
authors.forename: Paul N
authors.initials: PN
authors.lastname: Pfeiffer
authors.affiliation: VA HSR&D Center for Health Information and Communication, Indianapolis, IN, USA.|Regenstrief Institute, Inc., Indianapolis, IN, USA.
authors.forename: Linda S
authors.initials: LS
authors.lastname: Williams
authors.affiliation: Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Jason
authors.initials: J
authors.lastname: Mackey
authors.affiliation: Department of Neurology, Stroke Program, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Hughes
authors.affiliation: Department of Neurology, Stroke Program, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Lewis B
authors.initials: LB
authors.lastname: Morgenstern
mesh_terms: D000368:Aged; D002545:Brain Ischemia / Q000150:complications / Q000628:therapy*; D017028:Caregivers; D003866:Depressive Disorder / Q000150:complications / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012648:Self Care / Q000379:methods*; D012944:Social Support; D020521:Stroke / Q000150:complications / Q000628:therapy*; D017216:Telemedicine
keywords: Mobile technology; Post-stroke depression; Self-management