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Effects of chronic disease self-management programs for participants with higher depression scores: secondary analyses of an on-line and a small-group program

  • Original Research
  • Published:
Translational Behavioral Medicine

Abstract

Depression often accompanies chronic illness. Study aims included determining (1) the level of current depression (Patient Health Questionnaire (PHQ)-8 ≥ 10) for two sets of Chronic Disease Self-Management Programs (CDSMP) participants; (2) if depression or other outcomes improved for those with PHQ-8 ≥ 10; and (3) if outcomes differed for participants with or without depression. This study utilized longitudinal secondary data analysis of depression cohorts (PHQ-8 ≥ 10) from two independent translational implementations of the CDSMP, small-group (N = 175) and Internet-based (N = 110). At baseline, 27 and 55  % of the two samples had PHQ-8 10 or greater. This decreased to 16 and 37  % by 12  months (p < 0.001). Both depressed and non-depressed cohorts demonstrated improvements in most 12-month outcomes (pain, fatigue, activity limitations, and medication adherence). The CDSMP was associated with long-term improvements in depression regardless of delivery mode or location, and the programs appeared beneficial for participants with and without depression.

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Acknowledgments

This was an investigator-initiated secondary data analyses using data from two studies. The U.S. National Study was funded by the NCOA. Nancy Whitelaw was a principal investigator for the U.S. National Study and Audrey Alonis assisted with data collection and verification. The Healthy Living Canada Study was funded and administered by Alberta Health Services with software support and assistance from the NCOA. Doris Listoe of Alberta Health, Kathryn Plant at Stanford, and Jay Greenberg of NCOA were instrumental in administering and supporting the program and in collecting and managing data.

Conflict of interest

Laurent and Lorig receive royalties for the book that is used in the programs. There are no other potential conflicts of interest

Authors’ statement of and adherence to ethical standards

All procedures, including the informed consent process, were conducted in accordance with the ethical standards and were approved by the IRB boards of institutions involved in the two original studies.

Author information

Authors and Affiliations

  1. Stanford Patient Education Research Center, School of Medicine, Stanford University, 1000 Welch Road Rd., Suite 204, Palo Alto, CA, 94304, USA

    Philip L Ritter PhD, Diana D Laurent MPH & Kate Lorig DrPH

  2. Health Science Center, Texas A&M University, College Station, TX, USA

    Marcia G Ory PhD

Authors
  1. Philip L Ritter PhD
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  2. Marcia G Ory PhD
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  3. Diana D Laurent MPH
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  4. Kate Lorig DrPH
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Corresponding author

Correspondence to Philip L Ritter PhD.

Additional information

Healthy Living Canada was registered at ClinicalTrials.gov as NCT01047514, and the U.S. National study was registered as NCT01845857,

Implications

Practice: On-line and small-group generic self-management programs are effective for those with depression and should be considered for implementation as part of chronic disease management programs which include people with depression.

Policy: The Chronic Disease Self-Management Program (CDSMP) should be considered as an effective evidence-based program for people with depression.

Research: New methods are needed for analyzing and reporting the results of self-management programs with heterogeneous populations.

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Ritter, P.L., Ory, M.G., Laurent, D.D. et al. Effects of chronic disease self-management programs for participants with higher depression scores: secondary analyses of an on-line and a small-group program. Behav. Med. Pract. Policy Res. 4, 398–406 (2014). https://doi.org/10.1007/s13142-014-0277-9

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  • DOI: https://doi.org/10.1007/s13142-014-0277-9

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