1. A computer-assisted telephone collaborative care intervention provided by lay providers for the treatment of comorbid depression and at-risk drinking: Analysis of a randomized controlled trial.
- Author
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Kim HK, Melamed OC, Sloan M, Husain MI, Rodie DJ, Perivolaris A, Kurdyak P, Oslin DW, Geist R, Selby P, and Mulsant BH
- Subjects
- Humans, Treatment Outcome, Telephone, Computers, Depression epidemiology, Primary Health Care
- Abstract
Introduction: Virtual collaborative care for people with comorbid depression and at-risk drinking lacks strong evidence. Our aim was to assess the impact of 12 months of telephone collaborative care (tCC) versus enhanced usual care (eUC) on depression and drinking., Methods: We performed a secondary analysis of the Primary care Assessment and Research of a Telephone intervention for Neuropsychiatric conditions with Education and Resources study (PARTNERs), a blinded randomized controlled trial. We examined 144 participants with comorbid depression and at-risk drinking, of which 129 were from the original sample whose data have been published, and 15 were studied since the original report had been published. PARTNERs compared eUC consisting of usual care plus assessment of symptoms at baseline, and 4, 8, and 12 months later vs. tCC consisting of eUC plus telephone-based coaching and symptom monitoring provided by a lay mental health technician to patients supervised by a psychiatrist. The study assessed depression response and remission using logistic regression; we assessed trajectory of drinking using Generalized-estimating equations (GEE). Baseline factors associated with likelihood of not exceeding number of drinks at 12 months were identified using decision trees., Results: tCC produced a faster decline in the number of drinks than eUC (Wald Χ
2 = 9.47, p = 0.02). However, drinking and depression outcomes did not differ significantly between the two groups at the end of treatment. Higher alcohol consumption at baseline (≥18 standard drinks per week in the tCC group and ≥11 standard drinks per week in the eUC group) was associated with a higher likelihood of having at-risk drinking after 12 months of treatment., Conclusions: Our findings suggest that, compared to eUC, tCC may accelerate drinking reductions in patients with comorbid depression and at-risk drinking. Both treatments were equally effective at the end of treatment for both depression and drinking outcomes., Competing Interests: Declaration of competing interest BHM holds and receives support from the Labatt Family Chair in Biology of Depression in Late-Life Adults at the University of Toronto. He currently receives research support from Brain Canada, the Canadian Institutes of Health Research, the CAMH Foundation, the Patient-Centered Outcomes Research Institute (PCORI), the US National Institutes of Health (NIH), Capital Solution Design LLC (software used in this study), and HAPPYneuron (software used in another study founded by Brain Canada). Within the past five years, he has also received research support from Eli Lilly (medications for a NIH-funded clinical trial) and Pfizer (medications for a NIH-funded clinical trial). He has been an unpaid consultant to Myriad Neuroscience. DO reports consulting with Johnson and Johnson, grant support from the NIH, US Veterans Administration, Johnson and Johnson, and Myriad Genetics. MIH receives research support from the Brain and Behavior Research Foundation, Canadian Institutes of Health Research, CAMH Foundation, the PSI Foundation, and the University of Toronto. He has provided consultancy to Mindset Pharma, PsychEd Therapeutics, and Wake Network. PS holds the Vice Chair Research and Giblon Professor in Vice-Chair, Research and Giblon Professor in Family Medicine Research, a University Named Professorship at the University of Toronto. PS reports receiving grants and/or salary and/or research support in the past five years from the Juvenile Diabetes Research Foundation, Brain Canada Foundation, Medical Psychiatry Alliance, the Centre for Addiction and Mental Health, Health Canada, Ontario Ministry of Health, Canadian Institutes of Health Research (CIHR), Canadian Centre on Substance Use and Addiction, Public Health Agency of Canada (PHAC), Canadian Cancer Society Research Institute (CCSRI), Cancer Care Ontario, Ontario Institute for Cancer Research, National Institutes of Health (NIH), Pfizer Inc./Canada, and Bhasin Consulting Fund Inc. PS reports receiving consulting fees from Myelin and Associates. PS is an associate editor for Addiction. He also reports having been a member of the ASAM Fundamental of Addiction Medicine Planning Committee, a member of the Scientific Advisory Committee for the Canadian Centre on Substance Use and Addiction, a member of the Recommendations Task Force for the Canadian Hypertension Education Program, a member of the Canadian Task Force on Preventative Health Care for the Public Health Agency of Canada, Through an open tender process Johnson & Johnson, Novartis, and Pfizer Inc. are vendors of record for providing smoking cessation pharmacotherapy, free or discounted, for research studies in which PS is the principal investigator or co-investigator. OCM reports receiving grants and/or salary and/or research support from AMS Healthcare and the Centre for Addiction and Mental Health. All other authors have no conflict of interest to declare., (Copyright © 2023 Elsevier Inc. All rights reserved.)- Published
- 2024
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