Effectiveness of a psychoeducational group intervention in patients with mild/moderate depression in primary care (PC): randomized controlled trial

2011 ◽  
Vol 26 (S2) ◽  
pp. 616-616 ◽  
Author(s):  
R. Casañas ◽  
R. Catalan ◽  
M. Casas ◽  
A. Raya ◽  
E.M. Fernandez ◽  
...  
Keyword(s):  
Primary Care ◽  
Depressive Symptoms ◽  
Group Intervention ◽  
Intervention Group ◽  
Control Group ◽  
Medical Illness ◽  
Mild Depression ◽  
Psychoeducational Group ◽  
Moderate Depression ◽  
The Impact

BackgroundDue to the high prevalence of depressive symptoms in PC (Ayuso, 2001) is relevant to know the impact of the psychoeducation in the management of these symptoms to decrease the prevalence in the PC population.ObjectiveTo compare the effectiveness of a psychoeducational group intervention in patients with mild/moderate depression in PC.Methods242 participants older than 20 years with ICD-10 mild/moderate depression were recruited through nurse/general practice in 12 urban primary health care centers in Barcelona city. Randomization was realised by means of a computer program. Exclusion criteria: severe mental disorder, major depressive disorder, use of secondary mental health services and acute medical illness. The intervention group (IG) received a psycoeducational group program (12 weekly 1,5h sessions) leads by two nurses. The program was an adaptation of Coping With Depression (CWD) (Lewinsohn, 1989). The control group (CG) received TAU. Outcome measures: Sociodemographic, BDI and EuroQol-5D questionnaires pre-post intervention.Results232 patients were included, IG (n = 121) and CG (n = 112), of whom 86 patients had mild depression (BDI≤ 18) and 146 moderate depression (BDI≥ 19). The sample characteristics were as follow: 90% women with mean age of 53,27 (SD = 12,72)The intervention was associated with significant improvements in BDI (t(230) =-2.25; p = 0.025). Separately analyze the sample: Patients with mild depression: (t(83) =-2.52; p = 0.014).Patients with moderate depression: (t(141) =-2.62; p = 0.010). Posttest results show that this intervention has statistically significant effect on depressive symptoms in overall sample and in mild/moderate depression separately.ConclusionsThe psychoeducational intervention is effective treatment in both mild and moderate depressive symptoms in primary care.

scholarly journals Effectiveness of a Psychoeducational Group Intervention Carried Out by Nurses for Patients with Depression and Physical Comorbidity in Primary Care: Randomized Clinical Trial

2021 ◽  
Vol 18 (6) ◽  
pp. 2948
Author(s):  
Antonia Raya-Tena ◽  
María Isabel Fernández-San-Martin ◽  
Jaume Martin-Royo ◽  
Rocío Casañas ◽  
Glòria Sauch-Valmaña ◽  
...  
Keyword(s):  
Primary Care ◽  
Clinical Trial ◽  
Depressive Symptoms ◽  
Group Intervention ◽  
Therapeutic Response ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Psychoeducational Group ◽  
One Year ◽  
And Control

The association between physical illness and depression implies a poorer management of chronic disease and a lower response to antidepressant treatments. Our study evaluates the effectiveness of a psychoeducational group intervention led by Primary Care (PC) nurses, aimed at patients of this kind. It is a randomized, multicenter clinical trial with intervention (IG) and control groups (CG), blind response variables, and a one year follow-up. The study included 380 patients ≥50 years of age from 18 PC teams. The participants presented depression (BDI-II > 12) and a physical comorbidity: diabetes mellitus type 2, ischemic heart disease, chronic obstructive pulmonary disease, and/or asthma. The IG (n = 204) received the psychoeducational intervention (12 weekly sessions of 90 min), and the CG (n = 176) had standard care. The patients were evaluated at baseline, and at 4 and 12 months. The main outcome measures were clinical remission of depressive symptoms (BDI-II ≤ 13) and therapeutic response (reduction of depressive symptoms by 50%). Remission was not significant at four months. At 12 months it was 53.9% in the IG and 41.5% in the CG. (OR = 0.61, 95% CI, 0.49–0.76). At 4 months the response in the IG (OR = 0.59, 95% CI, 0.44–0.78) was significant, but not at 12 months. The psychoeducational group intervention led by PC nurses for individuals with depression and physical comorbidity has been shown to be effective for remission at long-term and for therapeutic response at short-term.

scholarly journals Identification of Education Models to Improve Health Outcomes in Arab Women with Pre-Diabetes

Nutrients ◽  
2019 ◽  
Vol 11 (5) ◽  
pp. 1113 ◽  
Author(s):  
Rasha Al-Hamdan ◽  
Amanda Avery ◽  
Andrew Salter ◽  
Dara Al-Disi ◽  
Nasser M. Al-Daghri ◽  
...  
Keyword(s):  
Primary Care ◽  
Lifestyle Modification ◽  
Intervention Group ◽  
Density Lipoprotein ◽  
Control Group ◽  
Haemoglobin A1c ◽  
Activity Data ◽  
The Impact ◽  
Modification Intervention ◽  
Group Comparisons

Few evaluations of interventions to delay or prevent type 2 diabetes mellitus (T2DM) in Saudi Arabia (SA) have been undertaken. The present study evaluates the impact of a 6-month intensive lifestyle modification intervention delivered in primary care. Females from SA with prediabetes, aged 18–55 years, were recruited with 190 participants eligible following screening and randomly allocated to receive a 3-month one-on-one, intensive lifestyle modification (intervention group (IG) n = 95) or standard guidance (control group (CG) n = 95). Participants completed questionnaires including demographic, dietary and physical activity data. Blood samples were collected at baseline, 3 and 6 months. A total of 123 (74 IG (age 40.6 ± 9.8 years; body mass index (BMI) 31.2 ± 7.0 kg/m2) and 49 CG (age 40.6 ± 12.7 years; BMI 32.3 ± 5.4 kg/m2)) participants completed the study. After 6 months, haemoglobin A1c (HbA1c; primary endpoint) significantly improved in the IG than CG completers in between-group comparisons (p < 0.001). Comparison between groups showed significant improvements in overall energy intake, total and high density lipoprotein (HDL)-cholesterol in favour of IG (p-values < 0.001, 0.04 and <0.001, respectively). BMI and weight change were not clinically significant in between group comparisons. A 6-month, intense one-on-one intervention in lifestyle modification significantly improves glycaemic and cardio metabolic profile of females living in SA with pre-diabetes delivered in a primary care setting. Longer duration studies, using the same intervention, may determine whether a meaningful weight loss secondary to improved diet can be achieved.

scholarly journals A single Epley manoeuvre can improve self-perceptions of disability (quality of life) in patients with cp-BPPV: A randomised controlled trial in primary care.

2020 ◽  
Author(s):  
Ricard Carrillo Muñoz ◽  
Jose Luis Ballve Moreno ◽  
Ivan Villar Balboa ◽  
Yolanda Rando Matos ◽  
Oriol Cunillera Puertolas ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Intervention Group ◽  
Control Group ◽  
Perceived Disability ◽  
Self Perceptions ◽  
Perceptions Of Disability ◽  
The Impact

Abstract Background: Posterior canal benign paroxysmal positional vertigo (pc-BPPV) causes physical, functional, and emotional impairment. The treatment of choice is the Epley manoeuvre (EM). The purpose of the study was to compare the impact of the EM and a sham manoeuvre in primary care on self-perceived disability. Method: Randomised, double-blind, sham-controlled clinical trial conducted in primary care with a follow-up of 1 year. Patients aged ≥18 years old diagnosed with pc-BPPV according to the Dix-Hallpike test (DHT) were randomised to an intervention (EM) group or a control (sham manoeuvre) group. The main study covariables were age, sex, history of depression and anxiety, presence of nystagmus in the DHT, patient-perceived disability assessed with the Dizziness Handicap Inventory-screening version (DHI-S). Data were analyzed using bivariate and multivariate mixed Tobit analyses. Results: Overall, 134 patients were studied: 66 in the intervention group and 68 in the control group. Median age was 52 years (interquartile range [IQR], 38.25–68.00 years) and 76.12% of the patients were women. The DHT triggered nystagmus in 40.30% of patients. The median total DHI-S score for the overall sample at baseline was 16 (IQR, 8.00–22.00); 16 [IQR, 10.5–24.0] vs 10 [6.0–14.0] for women vs men ( P <0.001) and 16 [IQR, 10.0-24.0] vs 12 [IQR, 8.0–18.0] for patients without nystagmus vs those with nystagmus ( P =0.033).Patients treated with the EM experienced a mean reduction of 2.03 points in DHI-S score over the follow-up period compared with patients in the sham group. Conclusion: Pc-BPPV affects the quality of life of primary care patients. A single EM can improve self-perceptions of disability by around 2 points on the DHI-S scale, Trial registration : ClinicalTrials.gov Identifier: NCT01969513. Retrospectively registered. First Posted: October 25, 2013. https://clinicaltrials.gov/ct2/show/NCT01969513

scholarly journals Impact of Epley manoeuvre on self-perceived disability: A randomised controlled trial in primary care

2020 ◽  
Author(s):  
Ricard Carrillo Muñoz ◽  
Jose Luis Ballve Moreno ◽  
Ivan Villar Balboa ◽  
Yolanda Rando Matos ◽  
Oriol Cunillera Puertolas ◽  
...  
Keyword(s):  
Primary Care ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Double Blind ◽  
Perceived Disability ◽  
Randomised Controlled ◽  
The Impact

Abstract Background: Posterior canal benign paroxysmal positional vertigo (pc-BPPV) causes physical, functional, and emotional impairment. The treatment of choice is the Epley manoeuvre (EM). The purpose of the study was to compare the impact of the EM and a sham manoeuvre in primary care on self-perceived disability.Method: Randomised, double-blind, sham-controlled clinical trial conducted in primary care with a follow-up of 1 year. Patients aged ≥18 years old diagnosed with pc-BPPV according to the Dix-Hallpike test (DHT) were randomised to an intervention (EM) group or a control (sham manoeuvre) group. The main study covariables were age, sex, history of depression and anxiety, presence of nystagmus in the DHT, patient-perceived disability assessed with the Dizziness Handicap Inventory-screening version (DHI-S). Data were analyzed using bivariate and multivariate mixed Tobit analyses. Results: Overall, 134 patients were studied: 66 in the intervention group and 68 in the control group. Median age was 52 years (interquartile range [IQR], 38.25–68.00 years) and 76.12% of the patients were women. The DHT triggered nystagmus in 40.30% of patients. The median total DHI-S score for the overall sample at baseline was 16 (IQR, 8.00–22.00); 16 [IQR, 10.5–24.0] vs 10 [6.0–14.0] for women vs men (P<0.001) and 16 [IQR, 10.0-24.0] vs 12 [IQR, 8.0–18.0] for patients without nystagmus vs those with nystagmus (P=0.033).Patients treated with the EM experienced a mean reduction of 2.03 points in DHI-S score over the follow-up period compared with patients in the sham group. Conclusion: Pc-BPPV affects the quality of life of primary care patients. A single EM can improve self-perceptions of disability by around 2 points on the DHI-S scale, Trial registration: ClinicalTrials.gov Identifier: NCT01969513. Retrospectively registered. First Posted: October 25, 2013. https://clinicaltrials.gov/ct2/show/NCT01969513

scholarly journals The impact of medication reviews conducted in primary care on hospital admissions and mortality - a randomized controlled trial

2019 ◽  
Author(s):  
Veronica Milos Nymberg ◽  
Cecilia Lenander ◽  
Beata Borgström Bolmsjö
Keyword(s):  
Primary Care ◽  
Elderly Patients ◽  
Usual Care ◽  
Frail Elderly ◽  
Hospital Admissions ◽  
Intervention Group ◽  
Control Group ◽  
Randomized Controlled ◽  
Medication Reviews ◽  
The Impact

Abstract Background Drug-related problems among the elderly population are common and increasing. Multi-professional medication reviews (MR) have arisen as a method to optimize drug therapy for frail elderly patients. Research has not yet been able to show conclusive evidence of the effect of MRs on mortality or hospital admissions. Aim The aim of this study was to assess the impact of MRs’ on hospital admissions and mortality after six and 12 months in a frail population of 369 patients in primary care in a randomized controlled study. Methods Patients were blindly randomized to an intervention group (receiving MRs) and a control group (receiving usual care). Descriptive data on mortality and hospital admissions at six and 12 months were collected. Survival analysis was performed for time to death and time to the first hospital admission within 12 months. Results Of the total number of 369 included patients, 182 were randomized to the intervention group and 187 to the control group. Most of the patients (75%) were females and lived in nursing homes. At six months, 50 patients of the baseline population (27%) in the control group had been admitted to hospital at least once, compared to 40 patients (21%) in the intervention group. At 12 months, the percentage had increased to 70 (37%) in the control group compared to 53 (29%) in the intervention group. Compared to usual care, we found that MRs reduced the risk of hospital admissions within 12 months by 36% (HR = 0.64, 95% CI 0.45-0.90), but found no difference on mortality (HR = 1.12, 95% CI 0.78-1.61) between the groups. Conclusion We suggest that MRs should be recommended in the care of frail elderly patients with expected benefits on hospital admissions.

scholarly journals Effectiveness of a Mindfulness-Based Group Intervention for Chinese University Students with Sleep Problems

2022 ◽  
Vol 19 (2) ◽  
pp. 755
Author(s):  
Lin Fu ◽  
Shuang Wei ◽  
Jin Cheng ◽  
Xueqi Wang ◽  
Yueyue Zhou ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
University Students ◽  
Sleep Quality ◽  
Repeated Measures ◽  
Group Intervention ◽  
Sleep Problems ◽  
Intervention Group ◽  
Control Group ◽  
Emotional Symptoms ◽  
Chinese University

The increasing prevalence of sleep disorders among university students should be taken seriously. Group counseling involving a mindfulness-based strategy may help prevent students from developing insomnia and subsequent mental health disorders. This study aimed to evaluate the ameliorating effects of a mindfulness-based group intervention on sleep problems and emotional symptoms in university students in China. Twenty-one university students (16 females, 22.71 ± 4.28 years) who were not on medication were recruited and assigned to the intervention group based on the criterion of high levels of sleep problems. Additionally, twenty-four university students (19 females, 24.50 ± 0.93 years) were included as a nonrandomized control group. Individuals in the intervention group participated in a two-hour group intervention once a week for eight sessions. All participants completed self-reported questionnaire baseline tests, postintervention tests, and one-month follow-ups on mindfulness, sleep quality, anxiety and depressive symptoms. Repeated-measures ANOVA was performed. The results revealed significant intervention effects, with significant differences observed between the two groups in mindfulness and sleep quality. However, there was no significant effect of the intervention on anxiety and depressive symptoms. This study contributes to a better understanding of the effectiveness of mindfulness-based intervention in addressing sleep problems in university students.

scholarly journals Impact of Pharmacist-Led Diabetes Management in Primary Care Clinics

2018 ◽  
Vol 9 (2) ◽  
pp. 17
Author(s):  
Benjamin Pontefract ◽  
Benjamin S. King ◽  
Cynthia A. King ◽  
David M Gothard
Keyword(s):  
Primary Care ◽  
Patient Satisfaction ◽  
Usual Care ◽  
Diabetes Management ◽  
Intervention Group ◽  
Control Group ◽  
Original Research ◽  
Diabetic Patients ◽  
Primary Care Clinics ◽  
The Impact

Purpose: Current literature supports that pharmacists effectively lower hemoglobin A1c (HbA1c) in diabetic patients. Little data exists on pharmacists’ effects on comorbidity management, patient satisfaction, or financial viability of these positions. This study looked to assess the impact of pharmacists on diabetes management compared to usual care. Methods: This multi-site, two-part study includes a retrospective chart review of patients referred to the pharmacist versus usual care within a large academic health system. The pharmacists collaborated under a consult agreement with primary care physicians. The second part of the study assessed patient satisfaction through an abbreviated CG-CAHPS survey. Results:A total of 206 patients with diabetes for an average of 12 years were included. The average patient age was 62 years with 60% of patients identifying as female and 81% as African-American. Patients were enrolled in a 2:1 fashion with 138 patients in the intervention group. Average baseline HbA1c was 10.1% in the intervention group and 9.3% in the control group (p= 0.0125). At 6 months, the mean change in HbA1c was -2.17% and 0.48% for the intervention and control groups respectively (p Conclusion: Pharmacists are effective at lowering HbA1c in primary care clinics, and patients were highly satisfied with these services. While direct revenue from this service did not meet cost, the pharmacist did positively affect outcomes that contribute to reimbursement. Treatment of Human Subjects: IRB review/approval required and obtained   Type: Original Research

scholarly journals Preventing postpartum depression using an educational video on infant crying

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Doi ◽  
T Fujiwara ◽  
A Isumi ◽  
A Nakai ◽  
K Ogita ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Postpartum Depression ◽  
Intervention Group ◽  
Control Group ◽  
Educational Video ◽  
Young Mothers ◽  
Infant Crying ◽  
Postpartum Depressive Symptoms ◽  
Significant Difference ◽  
The Impact

Abstract Background Perception of and reactive behaviors towards infant crying is one of the modifiable risk factors for postpartum depression. The aim of this study was to examine the impact of watching an educational video on infant crying within 1 week of age after delivery at maternity wards to reduce the prevalence of postpartum depressive symptoms at 1 month after giving birth. Methods Study design was a cluster randomized controlled trial (UMIN000015558). The intervention hospitals were randomly assigned, stratified by area and function of the hospital. Participants included 47 obstetrics hospitals or clinics out of 150 hospitals or clinics in Osaka Prefecture, Japan. In total, 44 hospitals or clinics completed the trial and 2,601 (intervention group=1,040, control group=1,561) caregivers responded to the questionnaire on postpartum depression. Mothers in the intervention group watched a 11-minute educational video, within 1 week of age, during hospitalization at maternity wards. Primary outcome in this study was postpartum depression assessed by the Edinburgh Postnatal Depression Scale as 9+, and assessed via questionnaire at a 1-month health checkup. Results In the intervention group, 142 (13.7%) mothers reported postpartum depression compared to 250 (16.0%) in the control group. Intention-to-treat analysis showed no significant difference in the prevalence of postpartum depression between the groups. However, among young mothers (&lt;25 years old), the analysis showed a 67% reduction in postpartum depression (OR:0.33, 95%CI:0.15-0.72). Conclusions Watching an educational video on infant crying did not reduce postpartum depression at 1 month after giving birth, but it was effective for young mothers aged less than 25 years old. It may be easier to introduce our approach to any opportunity for meeting mothers during perinatal period because it does not require specialized manpower and a significant amount of time for the intervention. Key messages The educational video on infant crying, “Baby Doesn't Stop Crying,” had no effect in preventing postpartum depressive symptoms. Among young mothers aged &lt;25 years, the educational video had a protective effect on postpartum depressive symptoms, which was not observed for mothers aged ≥25 years.

FACT effectiveness in primary care; a single visit RCT for depressive symptoms

2021 ◽  
pp. 009121742110105
Author(s):  
B Arroll ◽  
H Frischtak ◽  
R Roskvist ◽  
V Mount ◽  
F Sundram ◽  
...  
Keyword(s):  
Primary Care ◽  
Depressive Symptoms ◽  
Primary Care Clinic ◽  
Intervention Group ◽  
Psychosocial Assessment ◽  
Care Practice ◽  
Control Group ◽  
Number Needed To Treat ◽  
Care Clinic ◽  
The Mean

Background Patients with depressive symptoms are common in primary care. Brief, simple therapies are needed. Aim Is a focussed acceptance and commitment therapy (FACT) intervention more effective than the control group for patients with depressive symptoms in primary care at one week follow up? Design and setting: A randomised, blinded controlled trial at a single primary care clinic in Auckland, New Zealand. Methods Patients presenting to their primary care practice for any reason were recruited from the clinic waiting room. Eligible patients who scored ≥2 on the PHQ-2 indicating potential depressive symptoms were randomised using a remote computer to intervention or control groups. Both groups received a psychosocial assessment using the “work-love-play” questionnaire. The intervention group received additional FACT-based behavioural activation activities. The primary outcome was the mean PHQ-8 score at one week. Results 57 participants entered the trial and 52 had complete outcome data after one week. Baseline PHQ-8 scores were similar for intervention (11.0) and control (11.7). After one week, the mean PHQ-8 score was significantly lower in the intervention group (7.4 vs 10.1 for control; p<0.039 one sided and 0.078 two sided). The number needed to treat to achieve a PHQ-8 score ≤6 was 4.0 on intention to treat analysis (p = 0.043 two sided). There were no significant differences observed on the secondary outcomes. Conclusion This is the first effectiveness study to examine FACT in any population. The results suggest that it is effective compared with control, at one week, for patients with depressive symptoms in primary care.

scholarly journals The effectiveness of Nurture and Play: a mentalisation-based parenting group intervention for prenatally depressed mothers

2019 ◽  
Vol 20 ◽  
Author(s):  
S.J. Salo ◽  
M. Flykt ◽  
J. Mäkelä ◽  
Z. Biringen ◽  
M. Kalland ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Group Intervention ◽  
Intervention Group ◽  
Maternal Sensitivity ◽  
Reflective Functioning ◽  
Repeated Measure ◽  
Randomised Control Trial ◽  
Control Group ◽  
Treatment As Usual ◽  
Optimal Parenting

Abstract Aim: This randomised control trial (RCT) study examined the effectiveness of a mentalisation-based perinatal group intervention, Nurture and Play (NaP), in improving mother–infant interaction quality and maternal reflective functioning and in decreasing depressive symptoms. Background: Few preventive prenatal interventions have been developed for primary health care settings for mothers with depressive symptoms. Furthermore, previous prenatal intervention studies have only concentrated on reducing depressive symptoms and have not directly addressed enhancing optimal parenting qualities. Methods: The participants were 45 pregnant women with depressive symptoms. Women in the randomly assigned intervention group (n = 24) participated in the manualised, short-term NaP intervention group from pregnancy until the baby’s age of seven months, whereas control group women received treatment as usual (TAU). Maternal emotional availability (EA), reflective functioning (RF) and depressive symptoms were measured before the intervention and at the infants’ 12 months of age, and changes were evaluated using repeated measure analyses of variances (ANOVAs). Findings: The results showed that the intervention group displayed higher maternal sensitivity and RF and more reduction in depressive symptoms than the control group when babies were 12 months old. These findings provide preliminary support for the effectiveness of the NaP intervention.

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