TY - JOUR
KW - Activities of Daily Living
KW - Aged
KW - Antidepressive Agents/therapeutic use
KW - Arthritis/complications/psychology
KW - Depression/complications/therapy
KW - Female
KW - Humans
KW - Male
KW - Middle Aged
KW - Pain/etiology/psychology
KW - Psychotherapy
KW - Quality of Life
KW - Sickness Impact Profile
AU - E. H. Lin
AU - W. Katon
AU - M. Von Korff
AU - L. Tang
AU - J. W. Williams Jr
AU - K. Kroenke
AU - E. Hunkeler
AU - L. Harpole
AU - M. Hegel
AU - P. Arean
AU - M. Hoffing
AU - Della Penna
AU - C. Langston
AU - J. Unutzer
AU - IMPACT Investigators
A1 - 
AB - CONTEXT: Depression and arthritis are disabling and common health problems in late life. Depression is also a risk factor for poor health outcomes among arthritis patients. OBJECTIVE: To determine whether enhancing care for depression improves pain and functional outcomes in older adults with depression and arthritis. DESIGN, SETTING, AND PARTICIPANTS: Preplanned subgroup analyses of Improving Mood-Promoting Access to Collaborative Treatment (IMPACT), a randomized controlled trial of 1801 depressed older adults (> or =60 years), which was performed at 18 primary care clinics from 8 health care organizations in 5 states across the United States from July 1999 to August 2001. A total of 1001 (56%) reported coexisting arthritis at baseline. INTERVENTION: Antidepressant medications and/or 6 to 8 sessions of psychotherapy (Problem-Solving Treatment in Primary Care). MAIN OUTCOME MEASURES: Depression, pain intensity (scale of 0 to 10), interference with daily activities due to arthritis (scale of 0 to 10), general health status, and overall quality-of-life outcomes assessed at baseline, 3, 6, and 12 months. RESULTS: In addition to reduction in depressive symptoms, the intervention group compared with the usual care group at 12 months had lower mean (SE) scores for pain intensity (5.62 [0.16] vs 6.15 [0.16]; between-group difference, -0.53; 95% confidence interval [CI], -0.92 to -0.14; P =.009), interference with daily activities due to arthritis (4.40 [0.18] vs 4.99 [0.17]; between-group difference, -0.59; 95% CI, -1.00 to -0.19; P =.004), and interference with daily activities due to pain (2.92 [0.07] vs 3.17 [0.07]; between-group difference, -0.26; 95% CI, -0.41 to -0.10; P =.002). Overall health and quality of life were also enhanced among intervention patients relative to control patients at 12 months. CONCLUSIONS: In a large and diverse population of older adults with arthritis (mostly osteoarthritis) and comorbid depression, benefits of improved depression care extended beyond reduced depressive symptoms and included decreased pain as well as improved functional status and quality of life.
BT - JAMA : the journal of the American Medical Association
C5 - Healthcare Disparities
CP - 18
CY - United States
DO - 10.1001/jama.290.18.2428
IS - 18
JF - JAMA : the journal of the American Medical Association
N2 - CONTEXT: Depression and arthritis are disabling and common health problems in late life. Depression is also a risk factor for poor health outcomes among arthritis patients. OBJECTIVE: To determine whether enhancing care for depression improves pain and functional outcomes in older adults with depression and arthritis. DESIGN, SETTING, AND PARTICIPANTS: Preplanned subgroup analyses of Improving Mood-Promoting Access to Collaborative Treatment (IMPACT), a randomized controlled trial of 1801 depressed older adults (> or =60 years), which was performed at 18 primary care clinics from 8 health care organizations in 5 states across the United States from July 1999 to August 2001. A total of 1001 (56%) reported coexisting arthritis at baseline. INTERVENTION: Antidepressant medications and/or 6 to 8 sessions of psychotherapy (Problem-Solving Treatment in Primary Care). MAIN OUTCOME MEASURES: Depression, pain intensity (scale of 0 to 10), interference with daily activities due to arthritis (scale of 0 to 10), general health status, and overall quality-of-life outcomes assessed at baseline, 3, 6, and 12 months. RESULTS: In addition to reduction in depressive symptoms, the intervention group compared with the usual care group at 12 months had lower mean (SE) scores for pain intensity (5.62 [0.16] vs 6.15 [0.16]; between-group difference, -0.53; 95% confidence interval [CI], -0.92 to -0.14; P =.009), interference with daily activities due to arthritis (4.40 [0.18] vs 4.99 [0.17]; between-group difference, -0.59; 95% CI, -1.00 to -0.19; P =.004), and interference with daily activities due to pain (2.92 [0.07] vs 3.17 [0.07]; between-group difference, -0.26; 95% CI, -0.41 to -0.10; P =.002). Overall health and quality of life were also enhanced among intervention patients relative to control patients at 12 months. CONCLUSIONS: In a large and diverse population of older adults with arthritis (mostly osteoarthritis) and comorbid depression, benefits of improved depression care extended beyond reduced depressive symptoms and included decreased pain as well as improved functional status and quality of life.
PP - United States
PY - 2003
SN - 1538-3598; 0098-7484
SP - 2428
EP - 2429
EP - 
T1 - Effect of improving depression care on pain and functional outcomes among older adults with arthritis: a randomized controlled trial
T2 - JAMA : the journal of the American Medical Association
TI - Effect of improving depression care on pain and functional outcomes among older adults with arthritis: a randomized controlled trial
U1 - Healthcare Disparities
U2 - 14612479
U3 - 10.1001/jama.290.18.2428
VL - 290
VO - 1538-3598; 0098-7484
Y1 - 2003
ER -