TY - JOUR
KW - Adult
KW - Anti-HIV Agents/administration & dosage
KW - Antidepressive Agents/administration & dosage
KW - Cooperative Behavior
KW - Depression/drug therapy/etiology/nursing
KW - Female
KW - Follow-Up Studies
KW - Health Status
KW - HIV Infections/drug therapy/nursing/psychology
KW - Humans
KW - Male
KW - Medication Adherence
KW - Middle Aged
KW - Nurse Administrators
KW - Odds Ratio
KW - Patient Care Team
KW - Pharmacists
KW - Primary Health Care/methods/organization & administration
KW - Psychiatry
KW - Quality of Life
KW - Severity of Illness Index
KW - Time Factors
KW - Treatment Outcome
AU - J. M. Pyne
AU - J. C. Fortney
AU - G. M. Curran
AU - S. Tripathi
AU - J. H. Atkinson
AU - A. M. Kilbourne
AU - H. J. Hagedorn
AU - D. Rimland
AU - M. C. Rodriguez-Barradas
AU - T. Monson
AU - K. A. Bottonari
AU - S. M. Asch
AU - A. L. Gifford
A1 - 
AB - BACKGROUND: Depression is common among persons with the human immunodeficiency virus (HIV) and is associated with unfavorable outcomes. METHODS: A single-blind randomized controlled effectiveness trial at 3 Veterans Affairs HIV clinics (HIV Translating Initiatives for Depression Into Effective Solutions [HITIDES]). The HITIDES intervention consisted of an off-site HIV depression care team (a registered nurse depression care manager, pharmacist, and psychiatrist) that delivered up to 12 months of collaborative care backed by a Web-based decision support system. Participants who completed the baseline telephone interview were 249 HIV-infected patients with depression, of whom 123 were randomized to the intervention and 126 to usual care. Participant interview data were collected at baseline and at the 6- and 12-month follow-up visits. The primary outcome was depression severity measured using the 20-item Hopkins Symptom Checklist (SCL-20) and reported as treatment response (>/=50% decrease in SCL-20 item score), remission (mean SCL-20 item score, <0.5), and depression-free days. Secondary outcomes were health-related quality of life, health status, HIV symptom severity, and antidepressant or HIV medication regimen adherence. RESULTS: Intervention participants were more likely to report treatment response (33.3% vs 17.5%) (odds ratio, 2.50; 95% confidence interval [CI], 1.37-4.56) and remission (22.0% vs 11.9%) (2.25; 1.11-4.54) at 6 months but not 12 months. Intervention participants reported more depression-free days during the 12 months (beta = 19.3; 95% CI, 10.9-27.6; P < .001). Significant intervention effects were observed for lowering HIV symptom severity at 6 months (beta = -2.6; 95% CI, -3.5 to -1.8; P < .001) and 12 months (beta = -0.82; -1.6 to -0.07; P = .03). Intervention effects were not significant for other secondary outcomes. CONCLUSION: The HITIDES intervention improved depression and HIV symptom outcomes and may serve as a model for collaborative care interventions in HIV and other specialty physical health care settings where patients find their "medical home." TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00304915.
BT - Archives of Internal Medicine
C5 - Medical Home; HIT & Telehealth
CP - 1
CY - United States
DO - 10.1001/archinternmed.2010.395
IS - 1
JF - Archives of Internal Medicine
N2 - BACKGROUND: Depression is common among persons with the human immunodeficiency virus (HIV) and is associated with unfavorable outcomes. METHODS: A single-blind randomized controlled effectiveness trial at 3 Veterans Affairs HIV clinics (HIV Translating Initiatives for Depression Into Effective Solutions [HITIDES]). The HITIDES intervention consisted of an off-site HIV depression care team (a registered nurse depression care manager, pharmacist, and psychiatrist) that delivered up to 12 months of collaborative care backed by a Web-based decision support system. Participants who completed the baseline telephone interview were 249 HIV-infected patients with depression, of whom 123 were randomized to the intervention and 126 to usual care. Participant interview data were collected at baseline and at the 6- and 12-month follow-up visits. The primary outcome was depression severity measured using the 20-item Hopkins Symptom Checklist (SCL-20) and reported as treatment response (>/=50% decrease in SCL-20 item score), remission (mean SCL-20 item score, <0.5), and depression-free days. Secondary outcomes were health-related quality of life, health status, HIV symptom severity, and antidepressant or HIV medication regimen adherence. RESULTS: Intervention participants were more likely to report treatment response (33.3% vs 17.5%) (odds ratio, 2.50; 95% confidence interval [CI], 1.37-4.56) and remission (22.0% vs 11.9%) (2.25; 1.11-4.54) at 6 months but not 12 months. Intervention participants reported more depression-free days during the 12 months (beta = 19.3; 95% CI, 10.9-27.6; P < .001). Significant intervention effects were observed for lowering HIV symptom severity at 6 months (beta = -2.6; 95% CI, -3.5 to -1.8; P < .001) and 12 months (beta = -0.82; -1.6 to -0.07; P = .03). Intervention effects were not significant for other secondary outcomes. CONCLUSION: The HITIDES intervention improved depression and HIV symptom outcomes and may serve as a model for collaborative care interventions in HIV and other specialty physical health care settings where patients find their "medical home." TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00304915.
PP - United States
PY - 2011
SN - 1538-3679; 0003-9926
SP - 23
EP - 31
EP - 
T1 - Effectiveness of collaborative care for depression in human immunodeficiency virus clinics
T2 - Archives of Internal Medicine
TI - Effectiveness of collaborative care for depression in human immunodeficiency virus clinics
U1 - Medical Home; HIT & Telehealth
U2 - 21220657
U3 - 10.1001/archinternmed.2010.395
VL - 171
VO - 1538-3679; 0003-9926
Y1 - 2011
ER -