Accepted for/Published in: JMIR Mental Health
Date Submitted: Jul 26, 2018
Open Peer Review Period: Jul 29, 2018 - Sep 23, 2018
Date Accepted: Jan 23, 2019
(closed for review but you can still tweet)
Use of smartphone application to treat comorbidity depression with hypertension or diabetes I: a pilot study in Brazil and Peru
ABSTRACT
Background:
Depression is underdiagnosed and undertreated in primary health care. When associated with chronic physical disorders, it worsens outcomes. There is a clear gap in the treatment of depression in low- and middle-income countries (LMICs), where specialists and funds are scarce. Interventions supported by m-health technologies might help to reduce this gap. Mobile phones are widely used in LMICs offering potentially feasible and affordable alternatives for the management of depression among individuals with chronic disorders.
Objective:
To explore the potential effectiveness of a m-health intervention to help people with depressive symptoms and comorbid hypertension and/or diabetes and to explore the feasibility of conducting large randomized controlled trials (RCTs).
Methods:
Emotional Control (CONEMO) is a low-intensity psychoeducational 6-week intervention delivered via mobile phones assisted by a nurse for reducing depressive symptoms among individuals with diabetes and/or hypertension. CONEMO was tested in three pilot studies, one in São Paulo, Brazil, and two in Lima, Peru. Depressive symptoms were assessed using the PHQ-9 at enrollment and at six-week follow up.
Results:
The three pilot studies included a total of 66 people. Most participants were female between 41 and 60 years old. There was a reduction in depressive symptoms as measured by PHQ-9 in all pilot studies. 38/66 participants reached treatment success rate (PHQ9<10): 13 from São Paulo, 13 from first Lima pilot and 12 from second Lima pilot study. The intervention, the app and the support offered by nurse and nurse assistants were well received by participants in both settings.
Conclusions:
The intervention is feasible in both settings. Clinical data suggest that CONEMO might help to decrease participants’ depressive symptoms. The findings also indicate that it is possible to conduct RCTs in these settings.
Citation

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