One-year follow-up of the effectiveness of a lifestyle modification programme as an adjuvant treatment of depression in primary care: A randomised clinical trial.

An estimated 280 million individuals suffer from depression. Brief group interventions in Primary Healthcare Centres (PHCs) are recommended. One goal of these interventions is to educate people about healthy lifestyle habits, as they prevent the development of depression. This study aims to analyse the one-year follow-up results about the effectiveness of a Lifestyle Modification Programme (LMP) and an LMP plus Information and Communication Technologies (LMP + ICTs) when compared to Treatment as Usual (TAU). We conducted an open-label, multicentre, pragmatic, randomised clinical trial. A total of 188 individuals that visited a general practitioner and met the inclusion criteria were randomised. LMP consisted of six weekly 90-minute group sessions focusing on lifestyle improvement. LMP + ICTs was a hybrid of the LMP format with the inclusion of a wearable smartwatch. We used linear mixed models (with a random intercept and an unstructured covariance) to evaluate the effectiveness of the interventions, and an intention-to-treat analysis and Multiple Imputation technique for handling missing data. LMP + ICTs showed a statistically significant reduction on depressive symptoms (b = −2.68, 95 % CI = [−4.239, −1.133] p =.001) and sedentarism (b = −37.38, 95 % CI [−62.930, −11.833], p =.004) compared to TAU. Most of the dropouts were due to time restrictions. In long-term, LMPs plus ICTs administered in PHCs to people suffering from depression were effective in reducing depressive symptomatology and sedentarism comparing to TAU. More research is needed to enhance adherence to lifestyle recommendations. These promising programmes could be easily implemented in PHCs. Trial registration number : ClinicalTrials.gov Registry (NCT03951350). • This paper demonstrates the effectiveness in the long-term of a Lifestyle Modification Programme. • Interventions in a face-to-face group format at the primary care level are effective at reducing depression symptoms. • The relationship between several lifestyles and depression is confirmed. [ABSTRACT FROM AUTHOR]