TY - JOUR
KW - Depression/diagnosis/therapy
KW - Depressive Disorder, Major/diagnosis/therapy
KW - Humans
KW - Mental Health Services/organization & administration
KW - Minnesota
KW - Patient Care Team/organization & administration
KW - Program Evaluation
KW - Treatment Outcome
AU - R. C. Rossom
AU - L. I. Solberg
AU - E. D. Parker
AU - A. L. Crain
AU - R. Whitebird
AU - M. Maciosek
AU - B. Molitor
AU - M. Trangle
AU - J. Unutzer
A1 - 
AB - BACKGROUND: Little is known about the reach and impact of collaborative care for depression outside of clinical trials. OBJECTIVE: The objective of this study was to examine the effect of a collaborative care intervention for depression on the rates of depression diagnosis, use of specific depression codes, and treatment intensification. RESEARCH DESIGN: Evaluation of a staggered, multiple baseline implementation initiative. SUBJECTS: Patients receiving depression care in primary care clinics throughout Minnesota from February 2008 through March 2011. MEASURES: Data regarding depression diagnosis rates and codes, and measures of antidepressant intensification were provided by health insurers. RESULTS: Depression Improvement Across Minnesota: Offering a New Direction (DIAMOND) affected neither rates of depression recognition nor use of depression diagnostic codes, and the overall reach of DIAMOND was disappointingly small. Patients in DIAMOND had more episodes of treatment intensification than non-DIAMOND patients, but we were unable to account for depression severity in our analysis. CONCLUSIONS: DIAMOND did not affect depression recognition or diagnostic coding, but may have affected treatment intensification. Our results suggest that even strongly evidence-based interventions may have little contamination effects on patients not enrolled in the new care model.
BT - Medical care
C5 - Education & Workforce
CP - 11
CY - United States
DO - 10.1097/MLR.0000000000000602
IS - 11
JF - Medical care
N2 - BACKGROUND: Little is known about the reach and impact of collaborative care for depression outside of clinical trials. OBJECTIVE: The objective of this study was to examine the effect of a collaborative care intervention for depression on the rates of depression diagnosis, use of specific depression codes, and treatment intensification. RESEARCH DESIGN: Evaluation of a staggered, multiple baseline implementation initiative. SUBJECTS: Patients receiving depression care in primary care clinics throughout Minnesota from February 2008 through March 2011. MEASURES: Data regarding depression diagnosis rates and codes, and measures of antidepressant intensification were provided by health insurers. RESULTS: Depression Improvement Across Minnesota: Offering a New Direction (DIAMOND) affected neither rates of depression recognition nor use of depression diagnostic codes, and the overall reach of DIAMOND was disappointingly small. Patients in DIAMOND had more episodes of treatment intensification than non-DIAMOND patients, but we were unable to account for depression severity in our analysis. CONCLUSIONS: DIAMOND did not affect depression recognition or diagnostic coding, but may have affected treatment intensification. Our results suggest that even strongly evidence-based interventions may have little contamination effects on patients not enrolled in the new care model.
PP - United States
PY - 2016
SN - 1537-1948; 0025-7079
SP - 992
EP - 997
EP - 
T1 - A Statewide Effort to Implement Collaborative Care for Depression: Reach and Impact for All Patients With Depression
T2 - Medical care
TI - A Statewide Effort to Implement Collaborative Care for Depression: Reach and Impact for All Patients With Depression
U1 - Education & Workforce
U2 - 27479596
U3 - 10.1097/MLR.0000000000000602
VL - 54
VO - 1537-1948; 0025-7079
Y1 - 2016
ER -