Treatment Effects from UPBEAT: A Randomized Trial of Care Management for Behavioral Health Problems in Hospitalized Elderly Patients

Oslin, David W.; Thompson, Richard; Kallan, Michael J.; TenHave, Thomas R.; Blow, Frederic C.; Bastani, Roshan; Gould, Robert; Maxwell, Annette E.; Rosansky, Joel; Stone, William Van; Jarvik, Lissy F.

doi:10.1177/0891988703262539

Cited by 20 publications

(24 citation statements)

References 30 publications

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“…Lim, Lambert, and Gray (2003) also found that elderly under care management after hospital discharge had significantly better quality of life. Similar findings were observed in other studies (Allen & Meduna, 1999;Anderson-Loftin, 1995;Oslin et al, 2004).…”

Section: Introductionsupporting

confidence: 92%

The Assessment of a Hospital-Based Care Management Model for Long-Term Care Services

Chen¹,

Chuang²,

Wu³

et al. 2004

Journal of Nursing Research

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The purpose of this research was to assess the effectiveness of a hospital-based care management model on disabled elderly people. A before-and-after quasi-experimental design was adopted. A total of 331 disabled elderly people, residing in the Da-An District of Taipei City, participated in the study. Among them, 166 received care management, while the other 165 did not. The latter served as controls. Baseline and follow-up data collection were carried out before and after care management intervention. Logistic regression analysis was used to test the effects of care management on medical care expenditure, self-rated health, and satisfaction with long-term care arrangement. The results showed that those under care management, compared to the controls, were more likely to experience a decrease in medical care expenditure, and less likely to have a decrease in satisfaction with long-term care. The effects were statistically significant. However, there was no effect on self-rated health. The findings show that hospital-based care management is a viable option and has the potential to become an important segment in the delivery of long-term care services. More effort should be expended in its development and in the evaluation of its effectiveness.

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Section: Introductionsupporting

confidence: 92%

The Assessment of a Hospital-Based Care Management Model for Long-Term Care Services

Chen¹,

Chuang²,

Wu³

et al. 2004

Journal of Nursing Research

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“…First, the use of a depression severity scale to identify and monitor patients with a potentially poor prognosis may be a more feasible and reliable method than the use of diagnostic criteria, both because it may be used by non-psychiatrists, and because a rating scale may be more responsive to change. Second, the demonstrated persistence of depression symptoms in this population should motivate efforts to develop effective interventions, in spite of disappointing outcomes of RCTs of interventions targeting depression in this population (Oslin et al, 2004;Cole et al, 2006). Third, better intervention results may be achieved by targeting the intervention to those at greatest risk of a severe course.…”

Section: Discussionmentioning

confidence: 97%

Twelve‐month course of depressive symptoms in older medical inpatients

McCusker

Cole

Ciampi

et al. 2006

Int J Geriat Psychiatry

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“…35 That intervention involved assessment by a multidisciplinary team and assignment of a case coordinator who engaged patients in treatment and follow-up. The rate of attrition through withdrawal and death was as high as our rate (60%).…”

Section: Discussionmentioning

confidence: 99%

Systematic detection and multidisciplinary care of depression in older medical inpatients: a randomized trial

Cole¹

2006

Canadian Medical Association Journal

168

309

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Research M ajor depression occurs in 10%-30% of older medical inpatients 1-4 and appears to be associated with poor functional status, 5 increased use of hospital services 6,7 and reduced survival, 6,8-10 independent of the severity of physical illness. Despite the apparent benefits of treatment, 11 up to 90% of cases of depression are not detected by attending physicians during the course of usual hospital care, 3,12 and few patients receive optimal treatment in hospital or after discharge.12,13 Because a strategy of systematic detection and treatment has been shown to benefit elderly people with depression living in the community, 14-18we conducted a randomized clinical trial to evaluate whether systematic detection and multidisciplinary treatment of depression could be effective in reducing symptoms of depression and improving mental and physical health status in elderly medical inpatients. Our secondary objective was to determine the effect of the intervention on basic and instrumental activities of daily living, cognitive status, side-effects profile, mortality and health services utilization (length of hospital stay, and number of readmissions and emergency department visits). MethodsWe conducted the study at St. Mary's Hospital Center, a university-affiliated, primary acute care hospital in Montréal. The trial was approved by the hospital's Research Ethics Committee.All patients aged 65 years and over admitted from the emergency department to medical services between Oct. 19, 1999, and Nov. 1, 2002, were screened for eligibility by the research nurse. We excluded patients who (a) were admitted to the intensive care unit or cardiac monitoring unit for more than 48 hours; (b) had an imminently terminal illness; (c) did not speak or understand English or French; and (4) did not live on the Island of Montreal. Eligible patients who scored 4 or less on the Short Portable Mental Status Questionnaire (indicating at most mild cognitive impairment) were assessed using the Diagnostic Interview Schedule.19 Patients who were found to have major depression (as defined by DSM-IV criteria 20) and who consented to participate were enrolled. Enrolled patients were allocated to the intervention or usual-care groups with the use of block-size randomization and an allocation ratio of 1:1. The block size was varied ran- Systematic detection and multidisciplinary care of depression in older medical inpatients: a randomized trialBackground: Major depression is a frequent and serious disorder in older medical inpatients. Because the condition goes undetected and untreated in most of these patients, we conducted a randomized clinical trial to evaluate the effectiveness of a strategy of systematic detection and multidisciplinary treatment of depression in this population. Methods:Consecutive patients aged 65 years or more admitted to general medical services in a primary care hospital between October 1999 and November 2002 were screened for depression with the Diagnostic Interview Schedule (DIS) within 48 hours after admission. ...

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Treatment Effects from UPBEAT: A Randomized Trial of Care Management for Behavioral Health Problems in Hospitalized Elderly Patients

Cited by 20 publications

References 30 publications

The Assessment of a Hospital-Based Care Management Model for Long-Term Care Services

The Assessment of a Hospital-Based Care Management Model for Long-Term Care Services

Twelve‐month course of depressive symptoms in older medical inpatients

Systematic detection and multidisciplinary care of depression in older medical inpatients: a randomized trial

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