One-year follow-up of the effectiveness of a lifestyle modification programme as an adjuvant treatment of depression in primary care : A randomised clinical trial

Aguilar-Latorre, Alejandra and Oliván-Blázquez, Bárbara and Perez Algorta, Guillermo and Serrano-Ripoll, Maria J. and Olszewski, Linda E. and Turón-Lanuza, Alberto (2023) One-year follow-up of the effectiveness of a lifestyle modification programme as an adjuvant treatment of depression in primary care : A randomised clinical trial. Journal of Affective Disorders, 332. pp. 231-237. ISSN 0165-0327

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Abstract

Background An estimated 280 million individuals suffer from depression. Brief group interventions in Primary Healthcare Centres (PHCs) are recommended. One goal of these interventions is to educate people about healthy lifestyle habits, as they prevent the development of depression. This study aims to analyse the one-year follow-up results about the effectiveness of a Lifestyle Modification Programme (LMP) and an LMP plus Information and Communication Technologies (LMP + ICTs) when compared to Treatment as Usual (TAU). Methods We conducted an open-label, multicentre, pragmatic, randomised clinical trial. A total of 188 individuals that visited a general practitioner and met the inclusion criteria were randomised. LMP consisted of six weekly 90-minute group sessions focusing on lifestyle improvement. LMP + ICTs was a hybrid of the LMP format with the inclusion of a wearable smartwatch. We used linear mixed models (with a random intercept and an unstructured covariance) to evaluate the effectiveness of the interventions, and an intention-to-treat analysis and Multiple Imputation technique for handling missing data. Results LMP + ICTs showed a statistically significant reduction on depressive symptoms (b = −2.68, 95 % CI = [−4.239, −1.133] p = .001) and sedentarism (b = −37.38, 95 % CI [−62.930, −11.833], p = .004) compared to TAU. Limitations Most of the dropouts were due to time restrictions. Conclusions In long-term, LMPs plus ICTs administered in PHCs to people suffering from depression were effective in reducing depressive symptomatology and sedentarism comparing to TAU. More research is needed to enhance adherence to lifestyle recommendations. These promising programmes could be easily implemented in PHCs. Trial registration number: ClinicalTrials.gov Registry (NCT03951350).