Effectiveness of a Psychoeducational Group Intervention Carried Out by Nurses for Patients with Depression and Physical Comorbidity in Primary Care: Randomized Clinical Trial

Abstract

The association between physical illness and depression implies a poorer management of chronic disease and a lower response to antidepressant treatments. Our study evaluates the effectiveness of a psychoeducational group intervention led by Primary Care (PC) nurses, aimed at patients of this kind. It is a randomized, multicenter clinical trial with intervention (IG) and control groups (CG), blind response variables, and a one year follow-up. The study included 380 patients ≥50 years of age from 18 PC teams. The participants presented depression (BDI-II > 12) and a physical comorbidity: diabetes mellitus type 2, ischemic heart disease, chronic obstructive pulmonary disease, and/or asthma. The IG (n = 204) received the psychoeducational intervention (12 weekly sessions of 90 min), and the CG (n = 176) had standard care. The patients were evaluated at baseline, and at 4 and 12 months. The main outcome measures were clinical remission of depressive symptoms (BDI-II ≤ 13) and therapeutic response (reduction of depressive symptoms by 50%). Remission was not significant at four months. At 12 months it was 53.9% in the IG and 41.5% in the CG. (OR = 0.61, 95% CI, 0.49–0.76). At 4 months the response in the IG (OR = 0.59, 95% CI, 0.44–0.78) was significant, but not at 12 months. The psychoeducational group intervention led by PC nurses for individuals with depression and physical comorbidity has been shown to be effective for remission at long-term and for therapeutic response at short-term.

Effectiveness of a lifestyle modification programme in the treatment of depression symptoms in primary care

“…The findings of this study are consistent with other Spanish RCTs on psychoeducational group interventions delivered by PHC nurses for people with depression and physical comorbidity ( 40 , 41 ). Furthermore, they are also consistent with a multidisciplinary online programmes that integrates evidence-based tactics from the fields of lifestyle medicine ( 42 ), as well as with a recent pilot RCT about a group-based lifestyle medicine for depression ( 43 ).…”

A Pilot Nurse-Administered CBT Intervention for Insomnia in Patients with Schizophrenic Disorder: A Randomized Clinical Effectiveness Trial

“…If we delve into the analysis of quality of life based on the EQ-5D scale variables, which is a tool that has been used in various studies that evaluate insomnia [75,77,78] and has been utilised to measure the results of cognitive behavioural and psychoeducational interventions [19,61,79], we have observed that some variables improve significantly, but not all. These variables are Pain/Discomfort (p = 0.016) and Self-Care (p = 0.003).…”

A primary care psychoeducational group intervention for patients with depression and physical comorbidity: A qualitative study with a gender perspective

“…This study forms part of a wider, multi-centre study in which 27 PCT from around Catalunya (Spain) took part (Raya-Tena et al, 2021). The PSICODEP study evaluated the efficacy of a psychoeducational group intervention conducted by PC nurses for individuals with depression and physical comorbidity.…”

“…The qualitative research presented here is nested within the PSICODEP (psychoeducation, comorbidity, and depression) study, a clinical trial that obtained favourable results for depression remission and therapeutic response in individuals who presented both this condition and physical comorbidity. The participants received a psychoeducational group intervention given by previously trained PC nurses (Casañas et al, 2019; Raya‐Tena et al, 2021). Analysis of the data gathered from the nurses' diaries during the 12 intervention sessions, and their narratives regarding the individuals who attended them, can provide valuable information regarding dimensions not quantitatively researched.…”