Feasibility of an interactive voice response system for monitoring depressive symptoms in a lower-middle income Latin American country.
Feasibility of an interactive voice response system for monitoring depressive symptoms in a lower-middle income Latin American country.
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DOI：
10.1186/s13033-016-0093-3
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发表时间：
2016
影响因子：
3.6
通讯作者：
Piette JD
中科院分区：
文献类型：
--
作者：
Janevic MR;Aruquipa Yujra AC;Marinec N;Aguilar J;Aikens JE;Tarrazona R;Piette JD
需要创新的、可扩展的解决方案，以满足低收入和中等收入国家(LMIC)对精神卫生保健的巨大需求。我们在至少有中度抑郁症状的玻利维亚初级保健患者中进行了一项为期14周的自动电话交互语音应答(IVR)抑郁自我护理服务的可行性研究。我们分析了IVR呼叫完成率、IVR收集数据的可靠性和有效性以及参与者满意度。在32名参与者中，大多数是妇女(78%或25/32)和非土著(75%或24/32)。参与者在基线时有中度抑郁症状(PHQ-8评分平均13.3分，SD=33.5)，并报告总体健康状况良好或一般(88%或28/32)。每周IVR呼叫的54%(约占13个活动呼叫周中的7个)已完成。PHQ-8得分和IVR呼叫完成率在种族、教育程度、自我报告的抑郁症诊断、自我报告的总体健康状况、慢性病数量或健康素养方面都没有显著差异。IVR收集的PHQ-8得分的可靠性很好(Cronbach‘s Alpha=60.83)。几乎每一位参与者(97%)都对这项计划“大部分”或“非常”满意。许多人说，这个项目对他们的情绪和自我照顾是有益的，尽管受到一些技术困难和缺乏人际互动的限制。研究结果表明，IVR可用于为玻利维亚的抑郁症患者提供监测和自我护理教育。扩大分级护理服务，为更多的抑郁症患者提供与非专业卫生工作者的联系，并扩大mHealth的内容，可能会促进患者更多地参与，并在保持成本效益的同时提高其治疗价值。试用注册号ISRCTN ISRCTN 18403214。已于2016年9月14日注册。追溯注册
Innovative, scalable solutions are needed to address the vast unmet need for mental health care in low- and middle-income countries (LMICs). We conducted a feasibility study of a 14-week automated telephonic interactive voice response (IVR) depression self-care service among Bolivian primary care patients with at least moderately severe depressive symptoms. We analyzed IVR call completion rates, the reliability and validity of IVR-collected data, and participant satisfaction. Of the 32 participants, the majority were women (78 % or 25/32) and non-indigenous (75 % or 24/32). Participants had moderate depressive symptoms at baseline (PHQ-8 score mean 13.3, SD = 3.5) and reported good or fair general health status (88 % or 28/32). Fifty-four percent of weekly IVR calls (approximately 7 out of 13 active call-weeks) were completed. Neither PHQ-8 scores nor IVR call completion differed significantly by ethnicity, education, self-reported depression diagnosis, self-reported overall health, number of chronic conditions, or health literacy. The reliability for IVR-collected PHQ-8 scores was good (Cronbach’s alpha = 0.83). Virtually every participant (97 %) was “mostly” or “very” satisfied with the program. Many described the program as beneficial for their mood and self-care, albeit limited by some technological difficulties and the lack of human interaction. Findings suggest that IVR could feasibly be used to provide monitoring and self-care education to depressed patients in Bolivia. An expanded stepped-care service offering contact with lay health workers for more depressed individuals and expanded mHealth content may foster greater patient engagement and enhance its therapeutic value while remaining cost-effective. Trial registration ISRCTN ISRCTN 18403214. Registered 14 September 2016. Retrospectively registered