Doctor of Nursing Practice (DNP) Projects
Access Control
Open Access
Embargo Period
4-5-2019
Degree Program
Doctor of Nursing Practice
Degree Track
Post Master's DNP Completion
Year Degree Awarded
2019
Month Degree Awarded
May
Keywords
Mobile Health, Depression, Treatment, Primary Care, Adults, IntelliCare
Advisor
Dr. Jeungok Choi
DNP Project Chair
Dr. Jeungok Choi
DNP Project Outside Member Name
Dr. Mark Polatnik
Abstract
Abstract
Background: Mild depression is a common patient complaint in primary care, potentially impairing role function in multiple dimensions, with risk for escalation to severe Major Depressive Disorder (MDD), a chronic, recurring illness with multiple comorbidities at high emotional and economic cost to individuals, families, and society. Barriers to care include lack of access to Mental Health Specialists, financial constraints and stigma, all of which can cause escalation of symptoms to the point of disability and are magnified in underserved populations.
Purpose: The primary goal of this quality improvement (QI) project was to improve depression symptoms using the evidence-based mobile app IntelliCare to deliver Cognitive Behavioral Treatment (CBT) as part of an eight-week treatment protocol.
Methods: Mildly depressed adult primary care patients (PHQ-9 score 5-9) meeting inclusion criteria were asked to participate in an eight-week collaborative protocol in which they used the IntelliCare app at least weekly. Bi-weekly questionnaires were administered assessing patient symptoms, app usage and patient concerns. A post-intervention PHQ-9 was done at eight-weeks.
Results: The majority of participants (67%) completed the protocol with an average improvement in post-intervention PHQ-9 scores of 53%. The Wilcoxon-matched pairs test demonstrated a statistically significant improvement in post-protocol PHQ-9 scores (p
Implications to Practice: Willingness of patients to use the mobile health app IntelliCare with improvement in their depression symptoms support further study of its implementation in practice reducing barriers to care including financial constraints, limited access, and stigma.
Conclusion: Evidence-based mobile apps such as IntelliCare as part of a treatment plan for mild depression may help decrease barriers to treatment for depression and improve patient outcomes.
Keywords: depression, primary care, mobile apps, telehealth, adults
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