Telemedicine program reduces depression symptoms in adults with diabetes
BOSTON – Adults with diabetes who completed a remotely-delivered behavioral health program showed measurable reductions in depression, stress and anxiety, while also improving diabetes self-care and management, according to study findings presented here.
In a retrospective, observational cohort study of graduates from the AbilTo Diabetes program, researchers found that the depression scores of more than half of participants returned to normal after 8 weeks, leading to improved diabetes management and quality of life for patients.
“There’s consistent research showing that inadequate identification and treatment of behavioral health issues – depression, stress, anxiety – in individuals with diabetes impedes their successful lifestyle change and has a significant negative impact on clinical outcomes prognosis and cost,” Reena L. Pande, MD, MSC, of Brigham and Women’s Hospital and Harvard Medical School, said while presenting the findings at the American Diabetes Association’s 75th Scientific Sessions. “It makes perfect sense, and it’s a vicious cycle.”
Pande and Aimee Peters, LCSW, chief clinical officer at AbilTo, analyzed data from 392 adults with diabetes (mean age, 57.4 years; 52% female; mean baseline depression score 8.58) who completed the AbilTo Diabetes program. Participants completed an 8-week, 16-session program targeted to diabetics at risk for depression, stress, or anxiety.
Sessions were delivered remotely by phone or video with a therapist trained in cognitive behavioral therapy as well as a behavioral health coach (participants completed a session with each weekly). Within the cohort, 73% of participants opted for therapy via phone vs. video conferencing.
Researchers used the Depression, Anxiety, and Stress Scale (DASS-21) at baseline and after completion of the program to measure behavioral health outcomes; 36.5% of participants (n=143) had evidence of depression above the clinical threshold, or a DASS score above 9.
Among those with elevated baseline DASS values, depression scores declined 49%, from a mean score of 17.9 to a mean score of 8.7 (P < .0001); anxiety scores declined 46%; stress scores declined 43%.
Within the cohort, 76.9% of participants who saw declines in their depression score improved by at least one DASS severity category; in 63.6% of participants, depression scores returned to normal range.
Participants with greater degrees of depression severity at baseline saw the most improvement, Pande said.
Pande said researchers hope to provide “booster programs” in the future for those who complete the 8-week sessions to insure patients get additional support. Future studies are needed to gauge the impact on medical health outcomes, she said.
“The big picture to me is this [is a] recipe of putting together data, a technology platform to better enable our providers to do this kind of care, and people,” Pande said. “It’s this combined recipe of data, technology and people that has the greatest potential [to] harness what we can deliver and actually make meaningful change for people with diabetes.” – by Regina Schaffer
Pande RL, et al. 214-OR. Presented at: American Diabetes Association’s 75th Scientific Sessions; June 5-9, 2015; Boston.
Disclosure: Pande is chief medical officer and a shareholder of AbilTo. Peters is an employee and shareholder of AbilTo.