December 2018

In This Issue: Advances in Telehealth
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Telehealth Therapy for Depression in Veterans with Parkinson’s Disease

Feature Article

There is a critical need for treatments that address depression and mental healthcare barriers among the nearly 100,000 Veterans with Parkinson's Disease (PD) that receive VA care. Depression in PD (dPD) is a major complicating factor that affects several outcomes such as motor disability, cognitive status, quality of life, and caregiving relationships. Challenges in meeting the treatment needs of Veterans with dPD include a lack of clinicians knowledgeable about the interactions of PD and depression; considerable transportation barriers faced by these patients, combined with the geographical dispersion of specialized services within VA; and the paucity of effectiveness research that informs treatments for dPD.

This ongoing (2016–2020) HSR&D study seeks to overcome these challenges by using a telehealth delivery platform (i.e., video-to-home) to evaluate the effectiveness of a 10-session cognitive behavioral therapy (CBT) package tailored to address the unique needs of Veterans with PD and depression. The proposed treatment package also provides support and skills-training to the Veteran's caregiver (three sessions). Thus, this will be the first study to:

• Evaluate the effectiveness of telehealth-CBT for improving Veteran outcomes in dPD,
• Examine the impact of telehealth-CBT for dPD on a variety of caregiver outcomes, and
• Assess Veteran and caregiver perspectives on telehealth-CBT.

Investigators are enrolling 180 participants (90 Veterans and 90 caregivers). Half of the study cohort will receive the study intervention (telehealth-CBT), in addition to their standard medical care. The other half of the cohort will only receive standard medical care. The two groups will be compared at baseline, midpoint (week 5), endpoint (week 10), and 1 and 6-months post-treatment. Veterans will be assessed with standard measures of depression, anxiety, quality of life, and motor function, while caregivers will be evaluated with measures of caregiver burden, empowerment, and communication.

Findings: To be determined.

Impact:
Given the public health impact of improved depression treatment in Veterans with Parkinson's disease, the knowledge to be gained may be significant. Moreover, data gleaned from this study will guide the wide-scale implementation of this remote care model across the VA healthcare system – and facilitate a multisite initiative to further examine issues of dissemination, implementation, and effectiveness.

Principal Investigator: Alejandro Interian, PhD, is an HSR&D affiliate investigator and staff psychologist with the VA New Jersey Health Care System.  

Publications: None at this time.

View project abstract.