Introduction: Although depression and anxiety negatively impact patients’ responses to standard orthopedic treatment, mental health is not routinely addressed in orthopedic care. Digital mental health interventions may be a feasible, effective way to address mental health in orthopedic care settings, but recent literature calls for more comparison data between digital interventions and other treatment arms. This study compared changes in mental and physical health between orthopedic patients who received usual orthopedic care, patients who received usual care plus in-person psychological counseling, and patients who received usual care plus a digital mental health intervention.
Methods: In this study of adults who presented for subspecialty orthopedic care and reported symptoms of depression and/or anxiety, 51 received usual orthopedic care, 51 received usual care plus in-person psychological counseling, and 51 received usual care plus a digital mental health intervention. Outcomes were between-group differences in two-month longitudinal changes in PROMIS Depression and Anxiety scores (primary) and PROMIS Pain Interference and Physical Function scores (secondary).
Results: Compared to patients who just received usual orthopedic care, those who also received the digital mental health intervention reported meaningfully greater improvements in PROMIS Depression (-4.8 points), Pain Interference (-2.6), and Physical Function (2.7) (all P≤.04). Compared to patients who received in-person counseling plus usual care, those who received the digital mental health intervention plus usual care reported meaningfully greater improvement in PROMIS Physical Function (2.4, P=.04) and equivalent improvements in PROMIS Depression, Anxiety, and Pain Interference.
Impact: Incorporation of a digital mental health intervention into orthopedic care improved mental and physical health to a greater degree than usual orthopedic care alone and to at least a comparable degree as incorporation of in-person counseling. This novel implementation of software technology may improve healthcare quality and patient quality of life in a cost-effective manner for orthopedic patients with coexisting symptoms of depression and/or anxiety.
Organization – Washington University in St. Louis
Leo AJ, Schuelke MJ, Armbrecht MA, Hunt DM, Miller JP, Cheng AL