Author Response: Telephone-based Cognitive Behavioral Therapy for Depression in Parkinson Disease: A Randomized Controlled Trial.

Abstract

We thank Dr. Braillon for commenting on our article1 and for highlighting several advantages of increasing Parkinson disease (PD) patients' access to nonpharmacologic depression treatments. We share his interest in multidisciplinary PD care and his concern about the scarcity of such resources. Evidence-based, PD-informed depression treatment is critical to this approach, yet it remains largely inaccessible for several reasons, beyond considerable underdiagnosis of PD depression.2 People with PD (PWP) face a dearth of PD-informed mental health clinicians, often live far from specialized care centers, and contend with disability and transportation barriers to attending appointments.3,4 In studying PWPs' mental health care preferences (N = 769), we found that these factors contribute to strong interest in telehealth: 85% reported a preference for telehealth-to-home over clinic-based care, given the choice.4 We likewise view telehealth treatment not as a resource-poor alternative, but as a set of flexible, scalable, patient-centered modalities for extending the reach of specialized mental health care5 as it is in medicine.6 The large effects of telephone-based cognitive behavioral therapy—comparable with in-clinic treatment—suggest an exciting, near-term means of helping more patients alleviate depressive symptoms and improve PD self-management. We believe mental telehealth shows potential to begin countering inequities in community-based, interdisciplinary PD resources and thereby to advance personalized care by increasing patients' choice.