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dc.contributor.authorMontero Marín, Jesús
dc.contributor.authorAraya, Ricardo
dc.contributor.authorPérez Yus, Mari-Cruz
dc.contributor.authorMayoral, Fermín
dc.contributor.authorGili, Margalida
dc.contributor.authorBotella, Cristina
dc.contributor.authorBaños, Rosa
dc.contributor.authorCastro, Adoración
dc.contributor.authorRomero Sanchiz, Pablo
dc.contributor.authorLópez del Hoyo, Yolanda
dc.contributor.authorNogueira-Arjona, Raquel
dc.contributor.authorVives, Margalida
dc.contributor.authorRiera López del Amo, Antonio
dc.contributor.authorGarcia-Campayo, Javier
dc.date.accessioned2017-01-12T16:45:25Z
dc.date.available2017-01-12T16:45:25Z
dc.date.issued2016
dc.identifier.citationMONTERO-MARÍN, Jesús, et al. An Internet-Based Intervention for Depression in Primary Care in Spain: A Randomized Controlled Trial. Journal of medical Internet research, 2016, vol. 18, núm. 8 8ca_CA
dc.identifier.issn1439-4456
dc.identifier.issn1438-8871
dc.identifier.urihttp://hdl.handle.net/10234/165336
dc.description.abstractBackground: Depression is the most prevalent cause of illness-induced disability worldwide. Face-to-face psychotherapeutic interventions for depression can be challenging, so there is a need for other alternatives that allow these interventions to be offered. One feasible alternative is Internet-based psychological interventions. This is the first randomized controlled trial (RCT) on the effectiveness of an Internet-based intervention on depression in primary health care in Spain. Objective: Our aim was to compare the effectiveness of a low-intensity therapist-guided (LITG) Internet-based program and a completely self-guided (CSG) Internet-based program with improved treatment as usual (iTAU) care for depression. Methods: Multicenter, three-arm, parallel, RCT design, carried out between November 2012 and January 2014, with a follow-up of 15 months. In total, 296 adults from primary care settings in four Spanish regions, with mild or moderate major depression, were randomized to LITG (n=96), CSG (n=98), or iTAU (n=102). Research completers at follow-up were 63.5%. The intervention was Smiling is Fun, an Internet program based on cognitive behavioral therapy. All patients received iTAU by their general practitioners. Moreover, LITG received Smiling is Fun and the possibility of psychotherapeutic support on request by email, whereas CSG received only Smiling is Fun. The main outcome was the Beck Depression Inventory-II at 3 months from baseline. Mixed-effects multilevel analysis for repeated measures were undertaken. Results: There was no benefit for either CSG [(B coefficient=-1.15; P=.444)] or LITG [(B=-0.71; P=.634)] compared to iTAU, at 3 months. There were differences at 6 months [iTAU vs CSG (B=-4.22; P=.007); iTAU vs LITG (B=-4.34; P=.005)] and 15 months [iTAU vs CSG (B=-5.10; P=.001); iTAU vs LITG (B=-4.62; P=.002)]. There were no differences between CSG and LITG at any time. Adjusted and intention-to-treat models confirmed these findings. Conclusions: An Internet-based intervention for depression combined with iTAU conferred a benefit over iTAU alone in the Spanish primary health care system. Trial Registration: Clinicaltrials.gov NCT01611818; https://register.clinicaltrials.gov/prs/app/action/SelectProtocol? selectaction=Edit&uid=U0001NPQ&ts=2&cx=gctdh2&sid=S0003KJ6 (Archived by WebCite at http://www.webcitation.org/6jbsUvUDz)ca_CA
dc.description.sponsorShipThis study was financed by the Instituto de Salud Carlos III of the Spanish Ministry of Economy and Competitiveness with the PI10/01083 grant (Eficacia y coste-efectividad de un programa de psicoterapia asistida por ordenador para el tratamiento de la depresión mayor en atención primaria: estudio controlado, randomizado y cualitativo). The project also received funding from the Network for Prevention and Health Promotion in primary Care (RD12/0005) grant from the Instituto de Salud Carlos III of the Ministry of Economy and Competitiveness (Spain), co-financed with European Union ERDF funds.ca_CA
dc.format.extent13 p.ca_CA
dc.format.mimetypeapplication/pdfca_CA
dc.language.isoengca_CA
dc.publisherJMIR Publicationsca_CA
dc.relation.isPartOfJournal of medical Internet research, 2016, vol. 18, núm. 8ca_CA
dc.rights© Jesús Montero-Marín, Ricardo Araya, María C Pérez-Yus, Fermín Mayoral, Margalida Gili, Cristina Botella, Rosa Baños, Adoración Castro, Pablo Romero-Sanchiz, Yolanda López-Del-Hoyo, Raquel Nogueira-Arjona, Margarita Vives, Antoni Riera, Javier García-Campayo. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 26.08.2016. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.ca_CA
dc.rightsAtribución-ShareAlike 3.0 España*
dc.rights.urihttp://creativecommons.org/licenses/by/2.0/*
dc.subjectDepressionca_CA
dc.subjectRandomized Controlled Trial (RCT)ca_CA
dc.subjectInternet-based interventionca_CA
dc.titleAn Internet-Based Intervention for Depression in Primary Care in Spain: A Randomiz ed Controlled Trialca_CA
dc.typeinfo:eu-repo/semantics/articleca_CA
dc.identifier.doihttps://doi.org/10.2196/jmir.5695
dc.rights.accessRightsinfo:eu-repo/semantics/openAccessca_CA
dc.relation.publisherVersionhttp://www.jmir.org/2016/8/e231/ca_CA


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© Jesús Montero-Marín, Ricardo Araya, María C Pérez-Yus, Fermín Mayoral, Margalida Gili, Cristina Botella, Rosa Baños, Adoración Castro, Pablo Romero-Sanchiz, Yolanda López-Del-Hoyo, Raquel Nogueira-Arjona, Margarita Vives, Antoni Riera, Javier García-Campayo. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 26.08.2016.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.
Except where otherwise noted, this item's license is described as © Jesús Montero-Marín, Ricardo Araya, María C Pérez-Yus, Fermín Mayoral, Margalida Gili, Cristina Botella, Rosa Baños, Adoración Castro, Pablo Romero-Sanchiz, Yolanda López-Del-Hoyo, Raquel Nogueira-Arjona, Margarita Vives, Antoni Riera, Javier García-Campayo. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 26.08.2016. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.