Online Depression Care, Anytime Anywhere

Depression patients using online care program had improved outcomes

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) You read the news online. You socialize online. You shop online. Why not get your mental healthcare online too? It might soon be possible.

A small recent study found that an online care management program was helpful in treating depressed patients.

The patients were less depressed and happier with their care even a year after the treatment ended.

"Don't skip any of your mental health appointments."

The industry-funded study, led by Enid M. Hunkeler, MA, in the Division of Research at The Permanente Medical Group, Inc., aimed to find out whether an online management system could help treat patients with depression.

A group of 103 patients was randomly divided into two groups: 51 used the "eCare for Moods" online program, and 52 received regular mental health care.

The eCare program links to patients' medical records and lets doctors and nurses receive information that helps them determine how to treat the patient. The program lasted one year.

The eCare program included eight education modules for the patients, and they completed an average of 4.6 of these. There were 22 participants who finished all eight.

It also had a discussion group for those who completed all the modules, and patients and caregivers could send messages to one another over the system.

All the participants were interviewed by phone 6 months, 12 months, 18 months and 2 years after they were enrolled in the study. The telephone interviewers were not told whether each patient was doing eCare or regular care.

The surveys used a standard scale to estimate how depressed the patients were on a 6-point scale during different weeks of the study.

The results revealed that eCare patients fared slightly better than patients receiving usual care, though the difference was small enough that the margin of error could not completely rule out coincidence.

The eCare patients had an average 0.74 drop on the 6-point scale and tended to be depressed a little less often.

The regular care patients had about a 0.5 drop, but as a group, their depression severity was slightly better than that of the eCare patients at the start of the study.

Two years after the study began, 43 percent of the eCare patients and 30 percent of the usual care patients were no longer diagnosed with depression.

Basically, for every eight patients that received eCare, one would successfully end up without depression within two years.

The eCare patients also reported more satisfaction with their care and with learning new coping skills and more confidence in managing their depression. .0They also had an overall improvement in mental health.

These results match up with the experience of LuAnn Pierce, a clinical social worker in Colorado who has used similar technology with her clients.

"E-care and similar programs delivered online have consistently received good reviews from clients," Pierce said. "As a therapist, I use an online program similar to this with clients who learn and practice cognitive-behavioral skills and others to address anxiety and/or depression."

She said she sees this method of health care delivery becoming a reality for more and more people, including those whose needs traditional therapy does not meet as easily.

"This adjunct to traditional therapy offers the client a way to learn and practice between sessions, enhancing and reducing the time spent in traditional therapy," Pierce said. "These tools of the modern trade allow us as therapists to provide services to some who would not receive care otherwise due to mobility issues, social anxiety, transportation or fear of traditional mental health service delivery."

Although a larger study is necessary, the results of this study show that an online management system might be effective in treating mental health conditions.

"Self-care, continuous care management, and clinical decision support—all integrated and delivered online—can improve the lives of patients with recurrent or chronic depression," the authors wrote.

The study was published in the November issue of the journal Psychiatric Services. The research was funded by Eli Lilly (a pharmaceutical company) and the Kaiser Permanente Medical Group, Inc. of Northern California.

Permanente Medical Group has submitted two patents for online patient management systems. One author has received royalties from two publishers for manuals on collaborative care of mood disorders.

Reviewed by: 
Review Date: 
November 8, 2012
Last Updated:
November 11, 2012