Effectiveness of a psychoeducation group intervention conducted by primary healthcare nurses in patients with depression and physical comorbidity : study protocol for a randomized, controlled trial
Casañas, Rocio (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Martín Royo, Jaume (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Fernández San Martín, Maria Isabel (Institut Català de la Salut)
Raya Tena, Antonia (Institut Català de la Salut)
Mendioroz Peña, Jacobo (Institut Català de la Salut)
Sauch Valmaña, Glòria (Institut Català de la Salut)
Masa-Font, Roser (Institut Català de la Salut)
Casajuana Closas, Marc (Universitat Autònoma de Barcelona)
Fernandez Linares, Eva María (Institut Català de la Salut)
Cols-Sagarra, Cèlia (Institut Català de la Salut)
González-Tejón, Susana (Institut Català de la Salut. Centre d'Atenció Primària Raval Sud (Barcelona, Catalunya))
Foguet-Boreu, Quintí (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Martín Lopez, Luis Miguel (Universitat Autònoma de Barcelona)

Data:	2019
Resum:	Background: Depressive disorders are the third leading cause of consultation in primary care, mainly in patients with chronic physical illnesses. Studies have shown the effectiveness of group psychoeducation in reducing symptoms in depressive individuals. Our primary aim is to evaluate the effectiveness of an intervention based on a psychoeducational program, carried out by primary care nurses, to improve the remission/response rate of depression in patients with chronic physical illness. Secondarily, to assess the cost-effectiveness of the intervention, its impact on improving control of the physical pathology and quality of life, and intervention feasibility. Methods/design: A multicenter, randomized, clinical trial, with two groups and one-year follow-up evaluation. Economic evaluation study. Subjects: We will assess 504 patients (252 in each group) aged > 50 years assigned to 25 primary healthcare centers (PHC) from Catalonia (urban, semi-urban, and rural). Participants suffer from major depression (Beck depression inventory: BDI-II 13-28) and at least one of the following: type 2 diabetes mellitus, chronic obstructive pulmonary disease, asthma, and/or ischemic cardiopathy. Patients with moderate/severe suicide risk or severe mental disorders are excluded. Participants will be distributed randomly into the intervention group (IG) and control (CG). Intervention: The IG will participate in the psychoeducational intervention: 12 sessions of 90 min, once a week led by two Primary Care (PC) nurses. The sessions will consist of health education regarding chronic physical illness and depressive symptoms. Main measurements: Clinical remission of depression and/or response to intervention (BDI-II). Secondary measurements: Improvement in control of chronic diseases (blood test and physical parameters), drug compliance (Morinsky-Green test and number of containers returned), quality of life (EQ-5D), medical service utilization (appointments and hospital admissions due to complications), and feasibility of the intervention (satisfaction and compliance). Evaluations will be blinded, and conducted at baseline, post-intervention, and 12 months follow-up. Discussion: Results could be informative for efforts to prevent depression in patients with a chronic physical illness. Trial registration: NCT03243799 (registration date August 9, 2017).
Ajuts:	Instituto de Salud Carlos III PI16/184 Agència de Gestió d'Ajuts Universitaris i de Recerca SLT002/17/00096
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Depression ; Primary healthcare ; Chronic physical illness ; Nurses ; Psychoeducation
Publicat a:	BMC health services research, Vol. 19 (June 2019) , p. 427, ISSN 1472-6963

DOI: 10.1186/s12913-019-4198-7
PMID: 31242892

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