Positive impact of a family practice-based depression case management on patient's self-management ★★★

ObjectiveFamily practice-based depression case management improves depression symptoms and adherence to medication. The aim of this study was to explore the long-term effects of practice-based depression case management on patient depression-related self-management knowledge and activities.MethodsThis long-term follow-up of a randomized controlled trial study took place 12 months after the end of the 1-year case management intervention. We used a modified version of the depression-specific self-management questionnaire described in Ludman et al. [Psychol Med, 33 (2003) 1061–1070]. Analyses of self-management knowledge and activities used a linear mixed model accounting for practice cluster effects and treatment group.ResultsOf the 626 patients included at baseline, 439 (70.1%) participated 24 months later in this follow-up study, i.e., 12 months after the end of the intervention. Compared to control recipients, intervention recipients presented statistically significant increased knowledge of medication side-effects and felt more able to avoid situations that may trigger depression. They also tried more often to undertake enjoyable activities and set more time aside for these activities.ConclusionThis study suggests that case management improves depression-related self-management knowledge and activities in depressed primary care patients 12 months after the end of the intervention.Practice implicationsClinicians may consider introducing practice-based case management for improving patients' self-management activities and knowledge.