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Utilization of healthcare and prescription medicines after non-pharmacological interventions for depression - A 3-year register follow-up of an RCT in primary care

Bondesson, Elisabeth LU orcid ; Jöud, Anna LU orcid ; Stigmar, Kjerstin LU ; Ringqvist, Åsa LU ; Kraepelien, Martin ; Kaldo, Viktor ; Wettermark, Björn ; Forsell, Yvonne ; Petersson, Ingemar F. LU and Schelin, Maria E.C. LU (2022) In Preventive Medicine Reports 25.
Abstract

Depression is a common, recurrent disorder. There is a need for readily available treatments with few negative side effects, that demands little resources and that are effective both in the short- and long term. Our aim was to investigate the long-term effectiveness of two different interventions; physical exercise and internet-based cognitive behavioural therapy (internet-CBT), compared to usual care in patients with mild to moderate depression in a Swedish primary care setting. We performed a register-based 3-year follow-up study of participants in the randomized controlled trial REGASSA (n = 940) using healthcare utilization and dispensed medicines as outcomes. We found no difference between the three groups regarding proportion of... (More)

Depression is a common, recurrent disorder. There is a need for readily available treatments with few negative side effects, that demands little resources and that are effective both in the short- and long term. Our aim was to investigate the long-term effectiveness of two different interventions; physical exercise and internet-based cognitive behavioural therapy (internet-CBT), compared to usual care in patients with mild to moderate depression in a Swedish primary care setting. We performed a register-based 3-year follow-up study of participants in the randomized controlled trial REGASSA (n = 940) using healthcare utilization and dispensed medicines as outcomes. We found no difference between the three groups regarding proportion of participants consulting healthcare due to mental illness or pain during follow-up. Regarding number of consultations, there was no difference between the groups, except for consultations related to pain. For this outcome both treatment arms had significantly fewer consultations compared to usual care, during year 2–3, the risk ratio (RR) for physical exercise and internet-CBT was 0.64 (95% CI = 0.43–0.95) and 0.61 (95% CI = 0.41–0.90), respectively. A significantly lower proportion of patients in both treatment arms were dispensed hypnotics and sedatives year 2–3 compared to the usual care arm, RR for both physical exercise and internet-CBT was 0.72 (95% CI = 0.53–0.98). No other differences between the groups were found. In conclusion, considering long-term effects, both physical exercise and internet-CBT, being resource-efficient treatments, could be considered as appropriate additions for patients with mild to moderate depression in primary care settings. Trial registration: The original RCT was registered with the German Clinical Trial Register (DRKS study ID: DRKS00008745).

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author
; ; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Anxiety, Depression, Electronic health records, Healthcare utilization, Internet-based treatment, Long-term follow-up, Pain, Physical exercise, Prescription medicines, RCT
in
Preventive Medicine Reports
volume
25
article number
101658
publisher
Elsevier
external identifiers
  • scopus:85121264592
  • pmid:35127347
ISSN
2211-3355
DOI
10.1016/j.pmedr.2021.101658
project
Regassa-reg
language
English
LU publication?
yes
id
83b261bf-ccdf-4193-b932-730419a021f9
date added to LUP
2022-01-25 14:35:11
date last changed
2024-06-16 00:24:35
@article{83b261bf-ccdf-4193-b932-730419a021f9,
  abstract     = {{<p>Depression is a common, recurrent disorder. There is a need for readily available treatments with few negative side effects, that demands little resources and that are effective both in the short- and long term. Our aim was to investigate the long-term effectiveness of two different interventions; physical exercise and internet-based cognitive behavioural therapy (internet-CBT), compared to usual care in patients with mild to moderate depression in a Swedish primary care setting. We performed a register-based 3-year follow-up study of participants in the randomized controlled trial REGASSA (n = 940) using healthcare utilization and dispensed medicines as outcomes. We found no difference between the three groups regarding proportion of participants consulting healthcare due to mental illness or pain during follow-up. Regarding number of consultations, there was no difference between the groups, except for consultations related to pain. For this outcome both treatment arms had significantly fewer consultations compared to usual care, during year 2–3, the risk ratio (RR) for physical exercise and internet-CBT was 0.64 (95% CI = 0.43–0.95) and 0.61 (95% CI = 0.41–0.90), respectively. A significantly lower proportion of patients in both treatment arms were dispensed hypnotics and sedatives year 2–3 compared to the usual care arm, RR for both physical exercise and internet-CBT was 0.72 (95% CI = 0.53–0.98). No other differences between the groups were found. In conclusion, considering long-term effects, both physical exercise and internet-CBT, being resource-efficient treatments, could be considered as appropriate additions for patients with mild to moderate depression in primary care settings. Trial registration: The original RCT was registered with the German Clinical Trial Register (DRKS study ID: DRKS00008745).</p>}},
  author       = {{Bondesson, Elisabeth and Jöud, Anna and Stigmar, Kjerstin and Ringqvist, Åsa and Kraepelien, Martin and Kaldo, Viktor and Wettermark, Björn and Forsell, Yvonne and Petersson, Ingemar F. and Schelin, Maria E.C.}},
  issn         = {{2211-3355}},
  keywords     = {{Anxiety; Depression; Electronic health records; Healthcare utilization; Internet-based treatment; Long-term follow-up; Pain; Physical exercise; Prescription medicines; RCT}},
  language     = {{eng}},
  publisher    = {{Elsevier}},
  series       = {{Preventive Medicine Reports}},
  title        = {{Utilization of healthcare and prescription medicines after non-pharmacological interventions for depression - A 3-year register follow-up of an RCT in primary care}},
  url          = {{http://dx.doi.org/10.1016/j.pmedr.2021.101658}},
  doi          = {{10.1016/j.pmedr.2021.101658}},
  volume       = {{25}},
  year         = {{2022}},
}