Telehealth problem-solving therapy for depressed low-income homebound older adults. Academic Article uri icon

Overview

abstract

  • OBJECTIVE: To evaluate the acceptance and preliminary efficacy of in-home telehealth delivery of problem-solving therapy (tele-PST) among depressed low-income homebound older adults in a pilot randomized control trial designed to test its feasibility and preliminary efficacy. METHODS: A total of 121 homebound individuals who were age 50+ and scored 15+ on the 24-item Hamilton Rating Scale for Depression (HAMD) participated in the three-arm randomized control trial, comparing tele-PST with in-person PST and telephone support calls. Six sessions of the PST-primary care were conducted for the PST participants. For tele-PST, sessions 2-6 were conducted via Skype video call. Acceptance of tele-PST or in-person PST was measured with the 11-item, 7-point scale modified Treatment Evaluation Inventory (TEI). A mixed-effect regression analysis was used to examine the effects of treatment group, time, and the interaction term between treatment group and time on the HAMD scores. RESULTS: The TEI score was slightly higher among tele-PST participants than among in-person PST participants. The HAMD scores of tele-PST participants and in-person PST participants at a 12-week follow-up were significantly lower than those of telephone support call participants, and the treatment effects were maintained at a 24-week follow-up. The HAMD scores of tele-PST participants did not differ from those of in-person PST participants. CONCLUSIONS: Despite their initial skepticism, almost all participants had extremely positive attitudes toward tele-PST at the 12-week followup. Tele-PST also appears to be an efficacious treatment modality for depressed homebound older adults and to have significant potential to facilitate their access to treatment.

publication date

  • March 1, 2014

Research

keywords

  • Aging
  • Cognitive Behavioral Therapy
  • Depression
  • Homebound Persons
  • Poverty
  • Telemedicine

Identity

PubMed Central ID

  • PMC3519946

Scopus Document Identifier

  • 84898630526

Digital Object Identifier (DOI)

  • 10.1097/JGP.0b013e331823e2fce

PubMed ID

  • 23567376

Additional Document Info

volume

  • 22

issue

  • 3