Collaborative Care for the Treatment of Depression in Primary Care With a Low-Income, Spanish-Speaking Population

Abstract

The results suggest a model of care that is effective for a population at great risk for marginal mental health care, non-English-speaking Hispanics. Attention to patient preferences in primary care is essential to improve quality of depression treatment and may improve outcomes. In light of previous research that demonstrates insufficient evidence-based guidelines for patients with limited English proficiency and evidence that evaluation of patients in their nonprimary language or through an interpreter can lead to inaccurate mental health assessments, this study suggests an opportunity to improve the quality of mental health care for non-English-speaking Hispanics in the United States.

English Language Proficiency, Health Literacy, and Trust in Physician Are Associated with Shared Decision Making in Rheumatoid Arthritis

“…The Patient Health Questionnaire-9 (PHQ-9)(34, 35) was collected in the UCSF RA Cohort and the Geriatric Depression Scale short form (GDS)(36, 37) was obtained in the RA Panel to measure depressive symptoms. The RA Panel has used the Geriatric Depression scale consistently since 1989; the UCSF RA Cohort has used the PHQ-9 since 2006 as it has been validated in multiple languages (35, 38–40) and used among patients with limited literacy (41) and English language proficiency (42). We used cutoffs for depressive symptoms in each scale that allowed for comparable thresholds.…”

Collaborative Care for Depression among Patients with Limited English Proficiency: a Systematic Review

“…Table 1 summarizes the basic characteristics of the included studies. Fifteen articles, [35][36][37][38][39][40][41][42][43][44][45][46][47][48][49] representing nine studies with distinct patient populations (five randomized controlled trials, three cohort studies, and one case-control study), met the study criteria and are included in this review (see Fig. 1 for PRISMA flow diagram).…”

“…The non-RCTs did not have a usual care control group. [46][47][48] Depression measures were generally well described. All studies employed the same widely used and validated screening instrument, the Patient Health Questionnaire-9 (PHQ-9), to determine baseline depression diagnosis.…”

“…44,50 Other studies did not specify whether they used validated translations or translated their own instruments. [35][36][37][38][39][40][41]43,[45][46][47][48][49] All studies adequately described the interventions and the control conditions (if present in non-RCTs; Bcomparability^criteria in Table 3). Spanish-speaking study recruiters Relative to patients in the usual care group, patients in the intervention group were significantly more likely to have ≥50% improvement in PHQ-9 score (OR 4.5, 95% CI 0.18-5.12).…”

Collaborative care in real-world settings: barriers and opportunities for sustainability

“…With systematic care management, the care manager functions as a depression specialist working in conjunction with the primary care provider, offering supportive counseling and education to patients about the disorder, systematically following up with patients for symptom assessment, and tracking patient progress, preferably in a patient registry 9. The follow-up schedule is usually established at the first visit after medication has been initiated by the provider and often occurs by telephone.…”