Accepted for/Published in: JMIR Formative Research
Date Submitted: Jan 23, 2025
Date Accepted: Feb 16, 2026
Comparing Usual Care with Coordinated Clinician and Patient Use of Mobile Technology in Primary Care for Patients with Major Depressive Disorder: Pilot Study
ABSTRACT
Background:
Major Depressive Disorder (MDD) affects millions of Americans each year, and primary care is often where initial diagnosis and treatment occur. Evidence shows that self-management techniques, shared decision making, and goal setting are effective strategies for managing MDD symptoms, but primary care clinicians face barriers to successful implementation. Leveraging software and mobile technology may help alleviate these barriers and improve patient outcomes. Primary Care Path is a program that includes a patient-facing mobile app and an accompanying care team-facing web interface for supporting depression management in primary care.
Objective:
Evaluate use of Primary Care Path for major depressive disorder (MDD) management in primary care clinical settings and its impact on shared decision-making (SDM), treatment, symptoms, and goal setting and attainment.
Methods:
Four primary care clinical practices in the US were randomized to program use (intervention) versus usual care (control; no program). Intervention entailed practice adoption of the Primary Care Path program with patient participants engaging in app use for 18-weeks. Participants were patients aged ≥18 being treated for MDD who use smartphones. Online surveys (SDM-Q-9, medication changes, PAM-13, PHQ-9, and goal setting and attainment questions) were sent to all participants at baseline, 6, 12, and 18 weeks.
Results:
76 participants (34 intervention; 42 control) were enrolled; majority were female (79%; 76%), White (91%; 95%), non-Hispanic/Latino/a (85%; 100%), and employed (77%; 81%). At the end of study, no significant differences were observed in SDM-Q-9 between intervention and control. More intervention participants initiated antidepressant medication by weeks 12 (P=.03) and 18 (P=.04) and switched medications at a higher rate by weeks 6 (P=.009) and 12 (P=.04) versus control. All participants demonstrated significant improvement in PHQ-9 scores throughout the study period (P=.00), with no difference in change by group. At week 18, intervention participants felt more successful than control participants in achieving their personalized treatment goals.
Conclusions:
Coordinated use of this program by both patients and clinical team members in the primary care setting may enhance MDD management, leading to earlier medication optimization and helping patients achieve treatment goals that matter most to them. Clinical Trial: N/A
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