TY - JOUR
KW - Adult
KW - Aged
KW - Cluster Analysis
KW - Community Mental Health Services/organization & administration
KW - Depressive Disorder/therapy
KW - Female
KW - Humans
KW - Male
KW - Middle Aged
KW - Primary Health Care/organization & administration
KW - Remote Consultation
KW - Social Support
KW - Telephone
KW - United States
AU - A. J. Dietrich
AU - T. E. Oxman
AU - J. W. Williams Jr
AU - H. C. Schulberg
AU - M. L. Bruce
AU - P. W. Lee
AU - S. Barry
AU - P. J. Raue
AU - J. J. Lefever
AU - M. Heo
AU - K. Rost
AU - K. Kroenke
AU - M. Gerrity
AU - P. A. Nutting
A1 - 
AB - OBJECTIVE: To test the effectiveness of an evidence based model for management of depression in primary care with support from quality improvement resources. DESIGN: Cluster randomised controlled trial. SETTING: Five healthcare organisations in the United States and 60 affiliated practices. PATIENTS: 405 patients, aged > or = 18 years, starting or changing treatment for depression. INTERVENTION: Care provided by clinicians, with staff providing telephone support under supervision from a psychiatrist. MAIN OUTCOME MEASURES: Severity of depression at three and six months (Hopkins symptom checklist-20): response to treatment (> or = 50% decrease in scores) and remission (score of < 0.5). RESULTS: At six months, 60% (106 of 177) of patients in intervention practices had responded to treatment compared with 47% (68 of 146) of patients in usual care practices (P = 0.02). At six months, 37% of intervention patients showed remission compared with 27% for usual care patients (P = 0.014). 90% of intervention patients rated their depression care as good or excellent at six months compared with 75% of usual care patients (P = 0.0003). CONCLUSION: Resources such as quality improvement programmes can be used effectively in primary care to implement evidence based management of depression and improve outcomes for patients with depression.
BT - BMJ (Clinical research ed.)
C5 - HIT & Telehealth
CP - 7466
CY - England
DO - 10.1136/bmj.38219.481250.55
IS - 7466
JF - BMJ (Clinical research ed.)
N2 - OBJECTIVE: To test the effectiveness of an evidence based model for management of depression in primary care with support from quality improvement resources. DESIGN: Cluster randomised controlled trial. SETTING: Five healthcare organisations in the United States and 60 affiliated practices. PATIENTS: 405 patients, aged > or = 18 years, starting or changing treatment for depression. INTERVENTION: Care provided by clinicians, with staff providing telephone support under supervision from a psychiatrist. MAIN OUTCOME MEASURES: Severity of depression at three and six months (Hopkins symptom checklist-20): response to treatment (> or = 50% decrease in scores) and remission (score of < 0.5). RESULTS: At six months, 60% (106 of 177) of patients in intervention practices had responded to treatment compared with 47% (68 of 146) of patients in usual care practices (P = 0.02). At six months, 37% of intervention patients showed remission compared with 27% for usual care patients (P = 0.014). 90% of intervention patients rated their depression care as good or excellent at six months compared with 75% of usual care patients (P = 0.0003). CONCLUSION: Resources such as quality improvement programmes can be used effectively in primary care to implement evidence based management of depression and improve outcomes for patients with depression.
PP - England
PY - 2004
SN - 1756-1833; 0959-535X
SP - 602
T1 - Re-engineering systems for the treatment of depression in primary care: cluster randomised controlled trial
T2 - BMJ (Clinical research ed.)
TI - Re-engineering systems for the treatment of depression in primary care: cluster randomised controlled trial
U1 - HIT & Telehealth
U2 - 15345600
U3 - 10.1136/bmj.38219.481250.55
VL - 329
VO - 1756-1833; 0959-535X
Y1 - 2004
ER -