TY - JOUR
KW - Aged
KW - Aged, 80 and over
KW - Cooperative Behavior
KW - Delivery of Health Care, Integrated/methods
KW - Depression/therapy
KW - Humans
KW - MEDLINE
KW - Mental Health Services/organization & administration
KW - Middle Aged
KW - Primary Health Care
KW - Psychotherapy
KW - Quality Indicators, Health Care/statistics & numerical data
KW - Randomized Controlled Trials as Topic
AU - H. Chang-Quan
AU - D. Bi-Rong
AU - L. Zhen-Chan
AU - Z. Yuan
AU - P. Yu-Sheng
AU - L. Qing-Xiu
A1 - 
AB - OBJECTIVE: To determine the effective components and the feasibility of collaborative care interventions (CCIs) in the treatment of depression in older patients. METHODS: Systematic review of randomized controlled trials, in which CCIs were used to manage depression in patients aged 60 or older. RESULTS: We identified 3 randomized controlled trials involving 3930 participants, 2757 of whom received CCIs and the others received usual care. Collaborative care interventions were more effective in improving depression symptoms than usual care during each follow-up period. Compared with baseline, thoughts of suicide in subjects receiving CCIs significantly decreased (odds Ratio [OR], 0.52; 95% confidence intervals [CI], 0.35-0.77), but not that in those receiving usual care (OR, 0.85; 95% CI, 0.50-1.43). Subjects receiving CCIs were significantly more likely to report depression treatment (including any antidepressant medication and psychotherapy) than those receiving usual care during each follow-up period. Collaborative care interventions significantly increased depression-free days, but did not significantly increase outpatient cost. At 6 and 12 months postintervention, compared with those receiving usual care, participants receiving CCIs had lower levels of depression symptoms and thoughts of suicide. Moreover, participants receiving CCIs were significantly more likely to report antidepressant medication treatment, but were not significantly more likely to report psychotherapy. Collaborative care interventions with communication between primary care providers and mental health providers were no more effective in improving depression symptoms than CCIs without such communication. CONCLUSIONS: Collaborative care interventions are more effective for depression in older people than usual care and are also of high value. Antidepressant medication is a definitely effective component of CCIs, but communication between primary care providers and mental health providers seems not to be an effective component of CCIs. The effect of psychotherapy in CCIs should be further explored.
BT - Journal of investigative medicine : the official publication of the American Federation for Clinical Research
C5 - HIT & Telehealth; Healthcare Disparities
CP - 2
CY - Canada
DO - https://doi.org/10.2310/jim.0b013e3181954c2f
IS - 2
JF - Journal of investigative medicine : the official publication of the American Federation for Clinical Research
N2 - OBJECTIVE: To determine the effective components and the feasibility of collaborative care interventions (CCIs) in the treatment of depression in older patients. METHODS: Systematic review of randomized controlled trials, in which CCIs were used to manage depression in patients aged 60 or older. RESULTS: We identified 3 randomized controlled trials involving 3930 participants, 2757 of whom received CCIs and the others received usual care. Collaborative care interventions were more effective in improving depression symptoms than usual care during each follow-up period. Compared with baseline, thoughts of suicide in subjects receiving CCIs significantly decreased (odds Ratio [OR], 0.52; 95% confidence intervals [CI], 0.35-0.77), but not that in those receiving usual care (OR, 0.85; 95% CI, 0.50-1.43). Subjects receiving CCIs were significantly more likely to report depression treatment (including any antidepressant medication and psychotherapy) than those receiving usual care during each follow-up period. Collaborative care interventions significantly increased depression-free days, but did not significantly increase outpatient cost. At 6 and 12 months postintervention, compared with those receiving usual care, participants receiving CCIs had lower levels of depression symptoms and thoughts of suicide. Moreover, participants receiving CCIs were significantly more likely to report antidepressant medication treatment, but were not significantly more likely to report psychotherapy. Collaborative care interventions with communication between primary care providers and mental health providers were no more effective in improving depression symptoms than CCIs without such communication. CONCLUSIONS: Collaborative care interventions are more effective for depression in older people than usual care and are also of high value. Antidepressant medication is a definitely effective component of CCIs, but communication between primary care providers and mental health providers seems not to be an effective component of CCIs. The effect of psychotherapy in CCIs should be further explored.
PP - Canada
PY - 2009
SN - 1081-5589; 1081-5589
SP - 446
EP - 455
EP - 
T1 - Collaborative care interventions for depression in the elderly: a systematic review of randomized controlled trials
T2 - Journal of investigative medicine : the official publication of the American Federation for Clinical Research
TI - Collaborative care interventions for depression in the elderly: a systematic review of randomized controlled trials
U1 - HIT & Telehealth; Healthcare Disparities
U2 - 19174704
U3 - https://doi.org/10.2310/jim.0b013e3181954c2f
VL - 57
VO - 1081-5589; 1081-5589
Y1 - 2009
ER -