Translational Stroke Research

, Volume 8, Issue 1, pp 77–82 | Cite as

Interactive Voice Response—An Innovative Approach to Post-Stroke Depression Self-Management Support

  • Lesli E. SkolarusEmail author
  • John D. Piette
  • Paul N. Pfeiffer
  • Linda S. Williams
  • Jason Mackey
  • Rebecca Hughes
  • Lewis B. Morgenstern
Original Article


Automated interactive voice response (IVR) call systems can provide systematic monitoring and self-management support to depressed patients, but it is unknown if stroke patients are able and willing to engage in IVR interactions. We sought to assess the feasibility and acceptability of IVR as an adjunct to post-stroke depression follow-up care. The CarePartner program is a mobile health program designed to optimize depression self-management, facilitate social support from a caregiver, and strengthen connections between stroke survivors and primary care providers (PCPs). Ischemic stroke patients and an informal caregiver, if available, were recruited during the patient’s acute stroke hospitalization or follow-up appointment. The CarePartner program was activated in patients with depressive symptoms during their stroke hospitalization or follow-up. The 3-month intervention consisted of weekly IVR calls monitoring both depressive symptoms and medication adherence along with tailored suggestions for depressive symptom self-management. After each completed IVR call, informal caregivers were automatically updated, and, if needed, the subject’s PCP was notified. Of the 56 stroke patients who enrolled, depressive symptoms were identified in 13 (23 %) subjects. Subjects completed 74 % of the weekly IVR assessments. A total of six subjects did not complete the outcome assessment, including two non-study-related deaths. PCPs were notified five times, including two times for suicidal ideation and three times for medication non-adherence. Stroke patients with depressive symptoms were able to engage in an IVR call system. Future studies are needed to explore the efficacy of an IVR approach for post-stroke self-management and monitoring of stroke-related outcomes.


Post-stroke depression Self-management Mobile technology 



Research reported in this publication was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Number UL1TR000433. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Dr. Skolarus receives funding from NIH/NINDS K23 NS073685. Dr. Piette is a VA Senior Career Scientist and received additional support from grant number P30DK092926 from the US National Institutes of Health.

Compliance with Ethical Standards

Conflict of Interest


Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Lesli E. Skolarus
    • 1
    • 9
    Email author
  • John D. Piette
    • 2
    • 3
    • 4
  • Paul N. Pfeiffer
    • 5
    • 6
  • Linda S. Williams
    • 6
    • 7
  • Jason Mackey
    • 8
  • Rebecca Hughes
    • 1
  • Lewis B. Morgenstern
    • 1
  1. 1.Department of Neurology, Stroke ProgramUniversity of MichiganAnn ArborUSA
  2. 2.Ann Arbor Department of Veterans Affairs Center for Clinical Management ResearchAnn ArborUSA
  3. 3.School of Public HealthUniversity of MichiganAnn ArborUSA
  4. 4.School of MedicineUniversity of MichiganAnn ArborUSA
  5. 5.PsychiatryUniversity of MichiganAnn ArborUSA
  6. 6.VA HSR&D Center for Health Information and CommunicationIndianapolisUSA
  7. 7.Regenstrief Institute, Inc.IndianapolisUSA
  8. 8.Department of NeurologyIndiana University School of MedicineIndianapolisUSA
  9. 9.University of Michigan Medical CenterAnn ArborUSA

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