TY - JOUR
AU - N. A. Sowa
AU - P. Jeng
AU - A. M. Bauer
AU - J. M. Cerimele
AU - J. Unutzer
AU - Y. Bao
AU - L. Chwastiak
A1 - 
AB - OBJECTIVE: This study examined whether psychiatric case review was associated with depression medication modification in a large implementation program of collaborative care for depression in safety-net primary care clinics.     METHODS: Registry data were examined from an implementation of the collaborative care model in Washington State. A total of 14,960 adults from 178 primary care clinics who initiated care between January 1, 2008, and September 30, 2014, and who had a baseline Patient Health Questionnaire-9 (PHQ-9) score of 10 or higher were included. Rates of psychiatric case reviews and receipt of new depression medications were extracted from the registry for all patients and for a subset of patients who did not improve by eight weeks of treatment (did not achieve a PHQ-9 score of less than 10 or a reduction in PHQ-9 score of 50% or more, compared with baseline).     RESULTS: One-half of patients received a new depression medication. Psychiatric case review in any given month was associated with a doubling of the probability of receiving a new medication in the following month. Among patients who did not improve by eight weeks of treatment, a psychiatric case review during weeks 8-12 was associated with a higher rate of receipt of new medications during weeks 8-16 or weeks 8-20.     CONCLUSIONS: In a collaborative care program, psychiatric case review was associated with higher rates of subsequent receipt of a new depression medication. This finding supports the importance of psychiatric case review in reducing clinical inertia in collaborative care treatment of depression.
BT - Psychiatric Services
C5 - General Literature
CP - 5
DO - 10.1176/appi.ps.201700243
IS - 5
JF - Psychiatric Services
N2 - OBJECTIVE: This study examined whether psychiatric case review was associated with depression medication modification in a large implementation program of collaborative care for depression in safety-net primary care clinics.     METHODS: Registry data were examined from an implementation of the collaborative care model in Washington State. A total of 14,960 adults from 178 primary care clinics who initiated care between January 1, 2008, and September 30, 2014, and who had a baseline Patient Health Questionnaire-9 (PHQ-9) score of 10 or higher were included. Rates of psychiatric case reviews and receipt of new depression medications were extracted from the registry for all patients and for a subset of patients who did not improve by eight weeks of treatment (did not achieve a PHQ-9 score of less than 10 or a reduction in PHQ-9 score of 50% or more, compared with baseline).     RESULTS: One-half of patients received a new depression medication. Psychiatric case review in any given month was associated with a doubling of the probability of receiving a new medication in the following month. Among patients who did not improve by eight weeks of treatment, a psychiatric case review during weeks 8-12 was associated with a higher rate of receipt of new medications during weeks 8-16 or weeks 8-20.     CONCLUSIONS: In a collaborative care program, psychiatric case review was associated with higher rates of subsequent receipt of a new depression medication. This finding supports the importance of psychiatric case review in reducing clinical inertia in collaborative care treatment of depression.
PY - 2018
SP - 549
EP - 554
EP - 
T1 - Psychiatric Case Review and Treatment Intensification in Collaborative Care Management for Depression in Primary Care
T2 - Psychiatric Services
TI - Psychiatric Case Review and Treatment Intensification in Collaborative Care Management for Depression in Primary Care
U1 - General Literature
U2 - 29385955
U3 - 10.1176/appi.ps.201700243
VL - 69
Y1 - 2018
ER -