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Autordc.contributor.authorRojas Castillo, María Graciela 
Autordc.contributor.authorGuajardo, Viviana 
Autordc.contributor.authorMartinez, Pablo 
Autordc.contributor.authorCastro, Ariel 
Autordc.contributor.authorFritsch Montero, Rosemarie 
Autordc.contributor.authorMoessner, Markus 
Autordc.contributor.authorBauer, Stephanie 
Fecha ingresodc.date.accessioned2018-09-06T19:05:14Z
Fecha disponibledc.date.available2018-09-06T19:05:14Z
Fecha de publicacióndc.date.issued2018-04
Cita de ítemdc.identifier.citationJournal of Medical Internet Research Volumen: 20 Número: 4es_ES
Identificadordc.identifier.other10.2196/jmir.8803
Identificadordc.identifier.urihttps://repositorio.uchile.cl/handle/2250/151518
Resumendc.description.abstractBackground: In the treatment of depression, primary care teams have an essential role, but they are most effective when inserted into a collaborative care model for disease management. In rural areas, the shortage of specialized mental health resources may hamper management of depressed patients. Objective: The aim was to test the feasibility, acceptability, and effectiveness of a remote collaborative care program for patients with depression living in rural areas. Methods: In a nonrandomized, open-label (blinded outcome assessor), two-arm clinical trial, physicians from 15 rural community hospitals recruited 250 patients aged 18 to 70 years with a major depressive episode (DSM-IV criteria). Patients were assigned to the remote collaborative care program (n=111) or to usual care (n=139). The remote collaborative care program used Web-based shared clinical records between rural primary care teams and a specialized/centralized mental health team, telephone monitoring of patients, and remote supervision by psychiatrists through the Web-based shared clinical records and/or telephone. Depressive symptoms, health-related quality of life, service use, and patient satisfaction were measured 3 and 6 months after baseline assessment. Results: Six-month follow-up assessments were completed by 84.4% (221/250) of patients. The remote collaborative care program achieved higher user satisfaction (odds ratio [OR] 1.94, 95% CI 1.25-3.00) and better treatment adherence rates (OR 1.81, 95% CI 1.02-3.19) at 6 months compared to usual care. There were no statically significant differences in depressive symptoms between the remote collaborative care program and usual care. Significant differences between groups in favor of remote collaborative care program were observed at 3 months for mental health-related quality of life (beta 3.11, 95% CI 0.19-6.02). Conclusions: Higher rates of treatment adherence in the remote collaborative care program suggest that technology-assisted interventions may help rural primary care teams in the management of depressive patients. Future cost-effectiveness studies are needed.es_ES
Patrocinadordc.description.sponsorshipInnovation Fund for Competitiveness (FIC), Ministry of Economy, Development, and Tourism, through the Millennium Scientific Initiative IS130005 National Commission for Scientific and Technological Research (CONICYT) PII20150035 National Scientific and Technological Fund (FONDECYT)es_ES
Idiomadc.language.isoenes_ES
Publicadordc.publisherJMIR Publicationses_ES
Fuentedc.sourceJournal of Medical Internet Researches_ES
Palabras clavesdc.subjectPrimary health carees_ES
Palabras clavesdc.subjectDepressiones_ES
Palabras clavesdc.subjectTelemedicinees_ES
Palabras clavesdc.subjectRural health carees_ES
Palabras clavesdc.subjectMedically underserved areaes_ES
Títulodc.titleA Remote Collaborative Care Program for Patients with Depression Living in Rural Areas: Open-Label Triales_ES
Tipo de documentodc.typeArtículo de revista
dcterms.accessRightsdcterms.accessRightsAcceso a solo metadatoses_ES
Catalogadoruchile.catalogadorrgfes_ES
Indizaciónuchile.indexArtículo de publicación ISIes_ES


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