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Psychotherapy via telemedicine yields similar results to in-office therapy for veterans with MDD

Results from a randomized, controlled, open-label non-inferiority trial indicate psychotherapy administered via telemedicine had similar results to therapy via same-room treatment for older veterans with major depressive disorder.

“Many older adults with major depression, particularly veterans, do not have access to evidence-based psychotherapy. Telemedicine could increase access to best-practice care for older adults facing barriers of mobility, stigma, and geographical isolation,” study researcher Leonard E. Egede, MD, of the Medical University of South Carolina in Charleston, and colleagues wrote.

Leonard E. Egede

Researchers randomly assigned veterans with major depressive disorder (MDD) to eight sessions of behavioral activation for depression via telemedicine (n = 120) or in the same room (n = 121). Per-protocol analysis included 100 veterans in the telemedicine group and 104 in the same-room group. Veterans with active psychosis, dementia or substance dependence were excluded from the study.

Treatment response based on Geriatric Depression Scale scores did not significantly differ between veterans who received treatment via telemedicine (22; 90% CI, 15.52-29.38) and those who received treatment in the same room (21; 90% CI, 13.86-26.92), with an absolute difference of 2.06%.

Beck Depression Inventory scores did not significantly differ between treatment groups (19 vs. 19), with an absolute difference of 0.88%.

Response on the Structured Clinical Interview for DSM-IV, clinician version, did not significantly differ between veterans who received treatment via telemedicine (39; 90% CI, 34.74-51.93) and those who received treatment in the same room (46; 90% CI, 39.99-56.85), with a difference of –5.09%.

Analysis of intention-to-treat population had similar results, according to researchers.

“Telemedicine-delivered psychotherapy for older adults with major depression is not inferior to same-room treatment,” the researchers wrote. “This finding shows that evidence-based psychotherapy can be delivered, without modification, via home-based telemedicine, and that this method can be used to overcome barriers to care associated with distance from and difficulty with attendance at in-person sessions in older adults.” – by Amanda Oldt

Disclosure: The study received funding from the U.S. Department of Veterans Affairs. Please see the full study for a list of all other authors’ relevant financial disclosures.