TY - JOUR
AU - A. M. Lanigan
AU - E. F. Callen
AU - M. K. Filippi
AU - E. A. Robertson
AU - T. L. Clay
AU - A. Nederveld
AU - B. Fehnert
AU - L. Chrones
AU - M. L. Martin
AU - M. McCue
AU - C. M. Hester
A1 - 
AB - BACKGROUND: Major depressive disorder (MDD) affects millions of Americans each year and is often diagnosed and treated in primary care. Evidence shows that self-management techniques, shared decision-making (SDM), and goal setting are effective strategies for managing MDD, but the required collaboration between patients and primary care clinicians can be difficult. Primary Care Path is a program for supporting depression management in primary care that includes a patient-facing mobile app and an accompanying care team-facing web interface. Leveraging programs that provide clinician-facing software with companion patient-facing mobile technology may help patients and physicians align depression treatment and management goals, support effective SDM, alleviate barriers, and improve both clinical care and patient outcomes. OBJECTIVE: To pilot-test the use of Primary Care Path for MDD management in primary care and evaluate the impact of its use on depression treatment, symptoms, goal setting and attainment, and SDM. METHODS: Four primary care clinical practices in the United States were assigned to program use (2 practices; intervention) versus usual care (2 practices; control). Intervention practices used the Primary Care Path program in their clinics and engaged patient participants in app use for 18 weeks. Clinical care teams engaged with the patient-informed program portal primarily during patient encounters (in-person, virtual or calls). Patient participants were smartphone users aged 18 years and older who were being treated for MDD. Patient participants received online surveys (medication changes, Patient Health Questionnaire-9 [PHQ-9], goal setting and attainment questions, and Shared Decision-Making Questionnaire-9 [SDM-Q-9]) at baseline, 6, 12, and 18 weeks. RESULTS: A total of 76 patient participants (34 intervention; 42 control) were enrolled; the majority were female (27/34, 79%; 32/42, 76%), White (31/34, 91%; 40/42, 95%), non-Hispanic/Latino/a (29/34, 85%; 40/40, 100%), and employed (26/34, 77%; 34/42, 81%). Control patient participants' conversations with their medical providers increased over the study period, while intervention patient conversations with their medical providers decreased over time. At week 18, intervention participants felt more successful than control in achieving their personalized treatment goals. More intervention patient participants initiated antidepressant medication by weeks 12 (P=.03) and 18 (P=.04) and switched medications by weeks 6 (P=.009) and 12 (P=.04) versus control. All patient participants demonstrated significant improvement in PHQ-9 scores throughout the study period (P<.001), with no difference in change by group. Clinicians and patients indicated using the program to support SDM, but no significant differences were observed in SDM-Q-9 between intervention and control. CONCLUSIONS: Preliminarily, the use of this digital health program related to earlier medication optimization, earlier conversations between patients and medical providers, and patient attainment of goals that matter most to them, indicating that coordinated use of the program by both patients and clinical team members may enhance MDD management in primary care clinical settings.
AD - National Research Network, American Academy of Family Physicians, Leawood, KS, United States.; DARTNet Institute, 12635 East Montview Blvd, Suite 129, Aurora, CO, 80045, United States, 1-800-434-0278 ext 78.; Robert Graham Center, American Academy of Family Physicians, Washington, DC, United States.; Department of Family Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States.; Ctrl Group/Fora Health, London, United Kingdom.; Takeda Pharmaceuticals USA, Inc, Lexington, MA, United States.
AN - 42090328
BT - JMIR Form Res
C5 - HIT & Telehealth
DA - 05/2026
DO - 10.2196/71662
DP - NLM
ET - 20260506
JF - JMIR Form Res
LA - eng
N2 - BACKGROUND: Major depressive disorder (MDD) affects millions of Americans each year and is often diagnosed and treated in primary care. Evidence shows that self-management techniques, shared decision-making (SDM), and goal setting are effective strategies for managing MDD, but the required collaboration between patients and primary care clinicians can be difficult. Primary Care Path is a program for supporting depression management in primary care that includes a patient-facing mobile app and an accompanying care team-facing web interface. Leveraging programs that provide clinician-facing software with companion patient-facing mobile technology may help patients and physicians align depression treatment and management goals, support effective SDM, alleviate barriers, and improve both clinical care and patient outcomes. OBJECTIVE: To pilot-test the use of Primary Care Path for MDD management in primary care and evaluate the impact of its use on depression treatment, symptoms, goal setting and attainment, and SDM. METHODS: Four primary care clinical practices in the United States were assigned to program use (2 practices; intervention) versus usual care (2 practices; control). Intervention practices used the Primary Care Path program in their clinics and engaged patient participants in app use for 18 weeks. Clinical care teams engaged with the patient-informed program portal primarily during patient encounters (in-person, virtual or calls). Patient participants were smartphone users aged 18 years and older who were being treated for MDD. Patient participants received online surveys (medication changes, Patient Health Questionnaire-9 [PHQ-9], goal setting and attainment questions, and Shared Decision-Making Questionnaire-9 [SDM-Q-9]) at baseline, 6, 12, and 18 weeks. RESULTS: A total of 76 patient participants (34 intervention; 42 control) were enrolled; the majority were female (27/34, 79%; 32/42, 76%), White (31/34, 91%; 40/42, 95%), non-Hispanic/Latino/a (29/34, 85%; 40/40, 100%), and employed (26/34, 77%; 34/42, 81%). Control patient participants' conversations with their medical providers increased over the study period, while intervention patient conversations with their medical providers decreased over time. At week 18, intervention participants felt more successful than control in achieving their personalized treatment goals. More intervention patient participants initiated antidepressant medication by weeks 12 (P=.03) and 18 (P=.04) and switched medications by weeks 6 (P=.009) and 12 (P=.04) versus control. All patient participants demonstrated significant improvement in PHQ-9 scores throughout the study period (P<.001), with no difference in change by group. Clinicians and patients indicated using the program to support SDM, but no significant differences were observed in SDM-Q-9 between intervention and control. CONCLUSIONS: Preliminarily, the use of this digital health program related to earlier medication optimization, earlier conversations between patients and medical providers, and patient attainment of goals that matter most to them, indicating that coordinated use of the program by both patients and clinical team members may enhance MDD management in primary care clinical settings.
PY - 2026
SN - 2561-326x
SP - e71662
ST - Comparing Usual Care With Coordinated Clinician and Patient Use of Mobile Technology in Primary Care for Patients With Major Depressive Disorder: Practice-Based Pilot Study
T1 - Comparing Usual Care With Coordinated Clinician and Patient Use of Mobile Technology in Primary Care for Patients With Major Depressive Disorder: Practice-Based Pilot Study
T2 - JMIR Form Res
TI - Comparing Usual Care With Coordinated Clinician and Patient Use of Mobile Technology in Primary Care for Patients With Major Depressive Disorder: Practice-Based Pilot Study
U1 - HIT & Telehealth
U3 - 10.2196/71662
VL - 10
VO - 2561-326x
Y1 - 2026
ER -