Randomized Trial of a Depression Management Program in High Utilizers of Medical Care

Abstract

In depressed high utilizers not already in active treatment, a systematic primary care-based treatment program can substantially increase adequate antidepressant treatment, decrease depression severity, and improve general health status compared with usual care.

A Qualitative Study of Depression in Primary Care: Missed Opportunities for Diagnosis and Education

“…15 The US Preventive Services Task Force "recommends screening adults for depression in clinical practices that have systems in place to assure accurate diagnosis, effective treatment, and follow-up" with a grade B recommendation, 16 as such systems have been demonstrated to improve health status and, in some instances, to reduce health care costs. [17][18][19][20] There is a remarkable paucity of information about patients' understanding of depression and its treatment options, and the role patients play in choosing treatment options. The very limited evidence available suggests quite modest benefits of patient education materials for depression in isolation from more comprehensive interventions.…”

Implementation of Guideline-Based Care for Depression in Primary Care

“…chronic conditions including depression Hunkeler et al, 2000;Katzelnick et al, 2000;Rost, Nutting, Smith, Werner, & Duan, 2001;Simon, Von Korff, Rutter, & Wagner, 2000;Unutzer et al, 2002;Wells et al, 2000), anxiety (Roy-Byrne, Katon, Cowley, & Russo, 2001), alcohol use disorders (Oslin et al, 2003), and physical health conditions (Aubert et al, 1998;Delaronde, 2002;Rich et al, 1995), at a lower total cost of care (Rich et al, 1995), particularly among the more severely ill (Wasson et al, 1992).…”

Lessons from recent research on depression in primary care

“…The resulting treatment, however, was not sufficient to affect clinical outcomes. In contrast with results of these scree-ning interventions, programs of screening followed by systematic treatment have been clearly demonstrated to improve patient outcomes (Schulberg et al, 1996;Katzelnick et al, 2000). We conclude that increasing recognition of depression is a necessary, but not sufficient, step .toward providing effective depression treatment in primary care.…”