Health
Studies have found that the effectiveness of co-care for depression varies.
According to the National Institute of Mental Health, more than half of people with mental illness are untreated in the United States. As a result, primary care clinics can play a leading role in treating depression.
Studies show that a collaborative care program in which primary care providers work with depression care managers and designated psychiatric consultants can more than double the chances of improving depression outcomes.But a new study published in Health problems It shows that not all care is equal.
Looking at data from 11,003 patients in 135 primary care clinics in nine states, researchers find great variability in how well clinics carry out collaborative care programs. Did.
Depression improved significantly after 6 months in less than 25% of serviced patients in some clinics, and significantly improved in more than 75% of patients in other clinics. ..
This is the largest ever study of a joint care program for depression in primary care. The difference is huge and there is a big difference in where you get treatment for depression. “
Jürgen Unützer, lead author, professor, dean Psychiatry At the University of Washington School of Medicine
Researchers said the reasons for the large variability in success between clinics can be summarized in three key findings.
According to them, the most important finding was that how much help the clinic helped in implementing joint treatment made a big difference.
Clinics with more intensive implementation assistance may achieve nearly twice the results of depression as clinics with basic level implementation assistance, such as program literature and one-time training. did. More intensive support included year-long continuous follow-up of results and feedback from the UW Medical AIMS Center (Promoting Integrated Mental Health Solutions).
Other findings:
- Patients with more severe depression or illness in other ways are less likely to have good depression results.
- Poor, resource-poor patients can also have worse outcomes for depression. Clinics treating low-income patients, such as federal-qualified health centers, can struggle to achieve good depression outcomes and need additional support and resources to succeed there is.
- Clinics that have practiced collaborative care for several years have achieved somewhat better results than clinics that are still learning how to do collaborative care.
The collaborative care model was pioneered by the late Dr. Wayne Caton, who spent 30 years testing and developing approaches to improving the treatment of depression in primary care. Over 80 randomized controlled trials have validated the success of collaborative care models.
One of the most powerful aspects of co-care is to regularly monitor a patient’s depression and systematically adjust treatment if the patient does not improve as expected. Similarly, a clinic that regularly monitors a patient’s depression and systematically coordinates the program if the patient does not improve as expected may achieve substantially better results for the patient.
Source:
Journal reference:
Unützer, J. , et al. (2020) Changes in the effectiveness of co-care for depression: where is it important to receive care? Health problems. doi.org/10.1377/hlthaff.2019.01714..
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