Is long term care management effective for depression?

January 01, 0001

Is long term care management effective for depression?

There has been evidence of short term improvement with depression disease management. These US researchers tested whether low intensity disease management could provide longer term improvement (18 month follow up) in chronically depressed patients. The Depression in Primary Care (DPC) intervention was introduced in 5 primary care practices within the University of Michigan Health System, with 5 matched practices selected as control sites. There were 728 enrollees compared to 78 control patients receiving usual care. Symptoms were followed with Patient Health Questionnaire (PHQ-8) scores.

The researchers found: "DPC enrollees had sustained improvement in remission rates and reduced-function days over the full 18 months. Mean change in the PHQ-8 score over each 6-month interval was more favorable for DPC enrollees than for usual care patients, and the proportion of DPC enrollees in remission was higher at 6 months (43.4% vs 33.3%), 12 months (52.0% vs 33.9%), and 18 months (49.2% vs 27.3%). Multivariate analysis controlling for age, sex, ethnicity, baseline severity, and comorbid medical illness confirmed that DPC enrollees had significantly more reduction in depressive symptom burden over 18 months."

The researchers concluded: "The DPC intervention produced sustained improvement in clinical outcomes over 18 months in a cohort of chronically depressed patients with persistent symptoms despite active treatment."

Low intensity chronic disease management tools may be helpful for depression in primary care patients.

For the full abstract, click here.

Annals of Family Medicine 8(5):387-396, September 2010 © 2010 Annals of Family Medicine, Inc
Long-Term Clinical Outcomes of Care Management for Chronically Depressed Primary Care Patients: A Report From the Depression in Primary Care Project. Michael S. Klinkman, Sabrina Bauroth, Stacey Fedewa, et al. Correspondence to Michael Klinkman: [email protected]

Category: P. Psychological. Keywords: depression, elederly, cluster randomiazed controlled trial, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 19 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.