Technology-assisted Collaborative Care Program for Depressed Patients With Chronic Disease at Primary Care

Defined as a 50% reduction in a participant's Patient Health Questionnaire-9 Item (PHQ-9) score compared to the baseline.

The PHQ-9 minimum and maximum values are 0 and 27 points. Higher scores mean worse outcomes.

Defined as a change in a patient's depressive status from an initial score above the cutoff (PHQ-9 ≥ 10) and a follow-up score below this reference value (PHQ-9 < 10).

Defined as a patient's score on the scales and main components of the Short-Form 12 Health Survey (SF-12).

The SF-12 minimum and maximum values are 0 and 100 points. Higher scores mean better outcomes.

Defined as a patient's score on the Positive Problem Orientation and Rational Problem Solving Style subscales of the Social Problem-Solving Inventory - Revised Short Form (SPSI-R:S).

The SPSI-R:S minimum and maximum values are 0 and 100 points. Higher scores on the Positive Problem Orientation and the Rational Problem Solving Style, and lower scores on the Negative Problem Orientation, Impulsivity/Carelessness Style, and Avoidance Style mean better outcomes.

Defined as the achievement of therapeutic goal in the normalization of blood pressure according to the national standards established in the Clinical Guidelines of Primary or Essential Arterial Hypertension in people aged 15 or older. The therapeutic goal is to attain a value lower than 140/90 mmHg in non-diabetic patients and lower than 130/80 mmHg in patients with very high cardiovascular risk, diabetes, and/or proteinuric nephropathy. These values will be obtained from the patients' clinical records.

The ad-hoc instrument for evaluating the acceptability of the interventions is a self-report questionnaire that consists in 12 Likert-type items with four answer choices ranging from 1 (strongly agree) to 4 (strongly disagree). The construction of this instrument was based on the theoretical framework of acceptability, proposed by Sekhon et al., which characterizes seven dimensions for this concept: ethicality, affective attitude, burden, opportunity costs, perceived effectiveness, self-efficacy, and intervention coherence. For their interpretation, the participants' scores will be transformed into percentages (0% to 100%), with higher values representing more intervention acceptability.

Defined as the achievement of glycemic control, according to the national standards established in the Clinical Guidelines for Type II Diabetes Mellitus. Maintaining levels of glycosylated hemoglobin below 7% is regarded as a therapeutic goal in type II diabetes mellitus. These values will be obtained from the patients' clinical records.

The questionnaire about the utilization of health care services, adapted from the Chilean National Socioeconomic Characterization Survey, has a three-month recall period and records physician consultations or treatments, primary care and/or hospital emergencies, specialist medical treatment or mental health treatment, and hospitalizations, noting the total number of sessions (total days for hospitalizations) and the payment made for each session. The minimum number of sessions or total days for hospitalizations (and payment) are 0, there is no maximum value defined. A priori, we do not know if a higher number of sessions (consultations) mean a better or worse outcome. However, a higher humber of hospitalization days and higher payment mean worse outcomes.