Time to Remission for Depression with Collaborative Care Management (CCM) in Primary Care

Garrison, Gregory M.; Angstman, Kurt B.; O’Connor, Stephen S.; Williams, Mark D.; Lineberry, Timothy W.

doi:10.3122/jabfm.2016.01.150128

Cited by 35 publications

(26 citation statements)

References 26 publications

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“…The patients in our study were secure in the knowledge that the CM collaborated with others and would help them get health care when needed. Also, previous studies have shown how important collaborative care management is in supporting recovery for patients with depression (Garrison et al, 2016;Thota et al, 2012). This is also important from a primary care perspective, where access to care (Starfield, 2009) and continuity are vital (Starfield, 2011).…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies show that individual support and collaborative care are two factors strongly contributing to recovery for persons with depression, while also being cost‐effective (Donohue et al, ; Garrison et al, ). The patients in our study emphasized the importance of the CM's collaboration, especially with the GP, so that the number of care contacts could be reduced over time.…”

Section: Discussionmentioning

confidence: 99%

“…However, the increase in the number of patients with depression suggests that there is a need to improve treatment for these patients. Implementing a care manager (CM) at the primary care centre (PCC) has previously shown positive effects such as faster recovery and reduced symptoms for patients with depression (Gallo et al, 2013;Garrison, Angstman, O'Connor, Williams, & Lineberry, 2016;The Swedish Council on Health Technology Assessment, 2012). A collaborative care organization, such as a CM organization, has also shown costeffectiveness for health care (Johnson et al, 2014;Kates & Mach, 2007;Rost, Pyne, Dickinson, & LoSasso, 2005;Wang et al, 2007).…”

Section: Introductionmentioning

confidence: 99%

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An interview study of the care manager function—Opening the door to continuity of care for patients with depression in primary care

et al. 2019

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Aim To explore experiences among patients with depression of contact with a care manager at a primary care centre. Design A qualitative explorative study. Methods During spring and summer 2016, 20 individual face‐to‐face interviews were conducted with patients with experience of care manager contact. The material was analysed using systematic text condensation. Results The participants described that having contact with a care manager was a support in their recovery process. Care became more available, and the structured continuous contact and the care manager's availability contributed to a trusting relationship. Having someone to share their burden with was a relief. However, it was described as negative when the care manager was perceived as inflexible and not open to issues that the participants felt a need to discuss. For the care manager contact to be successful, there is a need for flexibility and individually tailored contact.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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An interview study of the care manager function—Opening the door to continuity of care for patients with depression in primary care

et al. 2019

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“…There is some evidence that recurrent depression has slower remission [29], but according to the similar frequency of maintenance antidepressant medication in both intervention and TAU groups at inclusion, we can assume that the rate of recurrent depression disorder was the same in both arms. Further, the high number of outcomes, assessed at baseline and at 3, 6, and 12 months, necessitated multiple statistical comparisons, thus increasing the possibility of type I errors.…”

Section: Discussionmentioning

confidence: 99%

“…These two factors can facilitate better depression outcomes [29–31]. Depression is complex, and the outcome of treatment often depends on the GP’s ability to connect with the patient during the consultation and her/his ability to choose proper treatment in agreement with the patient.…”

Section: Discussionmentioning

confidence: 99%

Use of a self-rating scale to monitor depression severity in recurrent GP consultations in primary care – does it really make a difference? A randomised controlled study

et al. 2017

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BackgroundLittle information is available about whether the use of self-assessment instruments in primary care affects depression course and outcome. The purpose was to evaluate whether using a depression self-rating scale in recurrent person-centred GP consultations affected depression severity, quality of life, medication use, and sick leave frequency.MethodsPatients in the intervention group met their GP regularly at least 4 times during the 3 months intervention. In addition to treatment as usual (TAU), patients completed a self-assessment instrument (Montgomery-Asberg Depression Rating Scale) on each occasion, and then GPs used the completed instrument as the basis for a person-centred discussion of changes in depression symptoms. The control group received TAU. Frequency of visits in the TAU arm was the result of the GPs’ and patients’ joint assessments of care need in each case.Depression severity was measured with Beck Depression Inventory-II (BDI-II), quality of life with EQ-5D, and psychological well-being with the General Health Questionnaire-12 (GHQ-12). Data on sick leave, antidepressant and sedatives use, and care contacts were collected from electronic patient records. All variables were measured at baseline and 3, 6, and 12 months. Mean intra-individual changes were compared between the intervention and TAU group.ResultsThere were no significant differences between the intervention and control group in depression severity reduction or remission rate, change in quality of life, psychological well-being, sedative prescriptions, or sick leave during the whole 12-month follow-up. However, significantly more patients in the intervention group continued antidepressants until the 6 month follow-up (86/125 vs 78/133, p < 0.05).ConclusionsWhen GPs used a depression self-rating scale in recurrent consultations, patients more often continued antidepressant medication according to guidelines, compared to TAU patients. However, reduction of depressive symptoms, remission rate, quality of life, psychological well-being, sedative use, sick leave, and health care use 4-12 months was not significantly different from the TAU group. These findings suggest that frequent use of depression rating scales in person-centred primary care consultations has no further additional effect on patients’ depression or well-being, sick leave, or health care use.Trial registrationClinicalTrials.gov Identifier: NCT01402206. Registered June 27 2011(retrospectively registered).Electronic supplementary materialThe online version of this article (doi:10.1186/s12875-016-0578-9) contains supplementary material, which is available to authorized users.

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Integrated and Collaborative Models of Care

Whitfield

Heddaeus

Härter

et al. 2023

Tasman’s Psychiatry

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Time to Remission for Depression with Collaborative Care Management (CCM) in Primary Care

Cited by 35 publications

References 26 publications

An interview study of the care manager function—Opening the door to continuity of care for patients with depression in primary care

An interview study of the care manager function—Opening the door to continuity of care for patients with depression in primary care

Use of a self-rating scale to monitor depression severity in recurrent GP consultations in primary care – does it really make a difference? A randomised controlled study

Integrated and Collaborative Models of Care

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