TY - JOUR
KW - Adult
KW - Ambulatory Care/utilization
KW - Antidepressive Agents/therapeutic use
KW - Depression/diagnosis/drug therapy/psychology
KW - Female
KW - Humans
KW - Male
KW - Mental Health Services/utilization
KW - Middle Aged
KW - Patient Care Management/statistics & numerical data
KW - Patient Compliance/statistics & numerical data
KW - Psychiatry/methods
KW - Questionnaires
KW - Telephone
KW - Treatment Outcome
AU - G. E. Simon
AU - E. J. Ludman
AU - B. H. Operskalski
A1 - 
AB - OBJECTIVE: This study evaluated the effectiveness of a structured telephone-based care management program for patients in a prepaid health plan receiving new antidepressant prescriptions from psychiatrists. METHODS: Potential participants were identified with computerized medical records and contacted by telephone. Eligible and consenting participants were randomly assigned to continued usual care (N=104) or to a three-session telephone care management program (N=103). Care management contacts included assessment of depressive symptoms, medication adherence, and medication side effects with structured feedback to treating psychiatrists. Effectiveness was assessed three and six months after randomization by blinded telephone assessments (depression scale on the Hopkins Symptom Checklist [SCL] and patient-rated global improvement). Computerized records were used to assess medication adherence and frequency of in-person follow-up visits. RESULTS: Compared with usual care, the care management intervention had no significant effect on the mean score of the SCL depression scale at six months, on the probability of 50 percent improvement in depressive symptoms (41 percent for care management and 37 percent for usual care), or on the probability of patient-rated improvement (57 percent for care management and 52 percent for usual care). Patients assigned to care management made significantly more medication management visits over six months (2.4 visits compared with 2.0 visits; p=.035), but there were no significant differences in rates of adequate medication treatment. CONCLUSIONS: This study found that a low-intensity telephone care management program did not appear to significantly improve clinical outcomes for patients starting antidepressant treatment. Compared with findings from earlier primary care studies, this study found that patients receiving care from a psychiatrist received more intensive treatment, although many still experienced poor outcomes.
BT - Psychiatric services (Washington, D.C.)
C5 - HIT & Telehealth
CP - 10
CY - United States
DO - 10.1176/appi.ps.57.10.1441
IS - 10
JF - Psychiatric services (Washington, D.C.)
N2 - OBJECTIVE: This study evaluated the effectiveness of a structured telephone-based care management program for patients in a prepaid health plan receiving new antidepressant prescriptions from psychiatrists. METHODS: Potential participants were identified with computerized medical records and contacted by telephone. Eligible and consenting participants were randomly assigned to continued usual care (N=104) or to a three-session telephone care management program (N=103). Care management contacts included assessment of depressive symptoms, medication adherence, and medication side effects with structured feedback to treating psychiatrists. Effectiveness was assessed three and six months after randomization by blinded telephone assessments (depression scale on the Hopkins Symptom Checklist [SCL] and patient-rated global improvement). Computerized records were used to assess medication adherence and frequency of in-person follow-up visits. RESULTS: Compared with usual care, the care management intervention had no significant effect on the mean score of the SCL depression scale at six months, on the probability of 50 percent improvement in depressive symptoms (41 percent for care management and 37 percent for usual care), or on the probability of patient-rated improvement (57 percent for care management and 52 percent for usual care). Patients assigned to care management made significantly more medication management visits over six months (2.4 visits compared with 2.0 visits; p=.035), but there were no significant differences in rates of adequate medication treatment. CONCLUSIONS: This study found that a low-intensity telephone care management program did not appear to significantly improve clinical outcomes for patients starting antidepressant treatment. Compared with findings from earlier primary care studies, this study found that patients receiving care from a psychiatrist received more intensive treatment, although many still experienced poor outcomes.
PP - United States
PY - 2006
SN - 1075-2730; 1075-2730
SP - 1441
EP - 1445
EP - 
T1 - Randomized trial of a telephone care management program for outpatients starting antidepressant treatment
T2 - Psychiatric services (Washington, D.C.)
TI - Randomized trial of a telephone care management program for outpatients starting antidepressant treatment
U1 - HIT & Telehealth
U2 - 17035563
U3 - 10.1176/appi.ps.57.10.1441
VL - 57
VO - 1075-2730; 1075-2730
Y1 - 2006
ER -