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Self‐care tools to treat depressive symptoms in patients with age‐related eye disease: a randomized controlled clinical trial
Author(s) -
Kamga Hortence,
McCusker Jane,
Yaffe Mark,
Sewitch Maida,
Sussman Tamara,
Strumpf Erin,
Olivier Sébastien,
Wittich Walter,
Moghadaszadeh Solmaz,
Freeman Ellen E
Publication year - 2017
Publication title -
clinical and experimental ophthalmology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.3
H-Index - 74
eISSN - 1442-9071
pISSN - 1442-6404
DOI - 10.1111/ceo.12890
Subject(s) - medicine , randomized controlled trial , visual acuity , anxiety , depression (economics) , health coaching , physical therapy , intervention (counseling) , diabetic retinopathy , psychiatry , diabetes mellitus , ophthalmology , economics , macroeconomics , endocrinology
Background Depression is very common in people with age‐related eye disease. Our goal was to determine if self‐care tools plus limited telephone support could reduce depressive symptoms in patients with age‐related macular degeneration or diabetic retinopathy. Design A single‐blind randomized controlled clinical trial was conducted at Maisonneuve‐Rosemont Hospital in Montreal, Canada. Participants Eighty participants were recruited. Methods To be eligible, participants must have had either late stage age‐related macular degeneration or diabetic retinopathy, at least mild depressive symptoms, and visual acuity better than 20/200. Half were randomized to the intervention arm and half to delayed intervention/usual care. The intervention consisted of large print written and audio tools incorporating cognitive‐behavioral principles plus three 10‐minute telephone calls from a lay coach. Eight‐week follow‐up data were collected by telephone. Main Outcome Measures The primary outcome was the 8‐week change in depressive symptoms as measured by the Patient Health Questionnaire‐9. Secondary outcomes included anxiety, life space and self‐efficacy. Results The baseline mean logMAR visual acuity was 0.37 (SD = 0.20), and the baseline mean Patient Health Questionnaire‐9 score was 9.5 (SD = 3.9) indicating moderate depressive symptoms. After adjusting for baseline imbalances in visual acuity, the intervention reduced depressive symptoms by 2.1 points more than usual care ( P = 0.040). The intervention was not associated with the secondary outcomes ( P > 0.05). Conclusions Self‐care tools plus telephone coaching led to a modest improvement in depressive symptoms in patients with age‐related eye disease. Additional research on how to maximize their effect is necessary.