Incorporating Patients' Social Determinants of Health into Hypertension and Depression Care: A Pilot Randomized Controlled Trial

Community Ment Health J. 2017 Aug;53(6):703-710. doi: 10.1007/s10597-017-0131-x. Epub 2017 Apr 4.

Abstract

The objective of this study was to carry out a randomized controlled pilot trial to test the effectiveness of an integrated intervention for hypertension and depression incorporating patients' social determinants of health (enhanced intervention) versus an integrated intervention alone (basic intervention). In all, 54 patients were randomized. An electronic monitor was used to measure blood pressure, and the nine-item Patient Health Questionnaire (PHQ-9) assessed depressive symptoms. Patients in the enhanced intervention had a significantly improved PHQ-9 mean change from baseline in comparison with patients in the basic intervention group at 12 weeks (p = 0.024). Patients in the enhanced intervention had a significantly improved systolic and diastolic blood pressure mean change from baseline in comparison with patients in the basic intervention group at 12 weeks (p = 0.003 and p = 0.019, respectively). Our pilot trial results indicate integrated care management that addresses the social determinants of health for patients with hypertension and depression may be effective.

Keywords: Depression; Hypertension; Intervention; Primary health care; Unmet needs.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Delivery of Health Care, Integrated / methods
  • Depression / complications*
  • Depression / therapy
  • Female
  • Humans
  • Hypertension / complications*
  • Hypertension / therapy
  • Male
  • Middle Aged
  • Pilot Projects
  • Social Determinants of Health*
  • Surveys and Questionnaires