Taking an evidence-based model of depression care from research to practice: making lemonade out of depression

General Hospital Psychiatry
Lydia M GrypmaJürgen Unützer

Abstract

The Improving Mood-Promoting Access to Collaborative Treatment (IMPACT) trial [randomized controlled trial (RCT)] found that collaborative care management of depression in older primary care patients was significantly more effective than the usual care. We examined how an adapted version of IMPACT is working in the "real-world" setting of an HMO 3 years after the conclusion of the trial. Two hundred ninety-seven adults treated according to IMPACT protocol "poststudy" (PS) at a large group model HMO were compared to the 141 participants (historical control) in the intervention arm of the RCT at the same site. The Patient Health Questionnaire (PHQ-9) was used to compare depression severity at baseline and 6 months. We also compared treatment contacts, use of antidepressants and psychotherapy and total health care costs. The RCT and PS groups were equivalent regarding baseline depression scores (14.5 vs. 14.2, P=.72), 6-month scores (5.6 vs. 6.3, P=.28) and percent experiencing 50% improvement in depression (68% vs. 70%, P=.83). Antidepressant use was similar (85% and 90%, P=.57). Treatment contacts were fewer in PS than RCT (14 vs. 20, P<.001). An adapted version of the IMPACT program implemented at a large HMO achieved similar c...Continue Reading

References

Jan 4, 1995·JAMA : the Journal of the American Medical Association·R Sturm, K B Wells
Jun 5, 2002·Psychiatric Services : a Journal of the American Psychiatric Association·Jürgen UnützerSabine Oishi
Dec 11, 2002·JAMA : the Journal of the American Medical Association·Jürgen UnützerUNKNOWN IMPACT Investigators. Improving Mood-Promoting Access to Collaborative Treatment
Dec 8, 2004·Health Affairs·Bruce FiremanJoe Selby
Dec 15, 2004·The Milbank Quarterly·Amy M KilbourneHarold Alan Pincus
Feb 8, 2005·General Hospital Psychiatry·Linda H HarpoleJürgen Unützer
Dec 7, 2005·Archives of General Psychiatry·Wayne J KatonJürgen Unützer
Sep 13, 2006·Administration and Policy in Mental Health·Margaret BlasinskyJürgen Unützer

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Citations

Mar 15, 2012·Journal of Clinical Psychology in Medical Settings·Justin M NashKevin S Masters
Feb 14, 2008·Current Psychiatry Reports·Karyn M Skultety, Rachel L Rodriguez
Apr 15, 2010·The International Journal of Clinical and Experimental Hypnosis·Barbara S McCann, Sara J Landes
Sep 23, 2008·The American Journal of Nursing·JoAnn Damron-Rodriguez
Mar 19, 2011·The Journal of Ambulatory Care Management·Mary ButlerTimothy Wilt
Mar 29, 2007·Annals of Family Medicine·Bradley N GaynesMaurizio Fava
Sep 28, 2013·Administration and Policy in Mental Health·Leslie K HascheEnola K Proctor
Dec 6, 2007·Expert Review of Neurotherapeutics·Jeanne Leventhal AlexanderEnid M Hunkeler
Dec 6, 2007·Expert Review of Neurotherapeutics·Jeanne Leventhal Alexander, Lorraine Dennerstein
Jan 21, 2011·Journal of the American Pharmacists Association : JAPhA·Patrick R FinleyStephanie N Kiser
Apr 21, 2012·American Journal of Preventive Medicine·Verughese JacobUNKNOWN Community Preventive Services Task Force
May 23, 2012·Primary Care·Jürgen Unützer, Mijung Park
Sep 29, 2011·The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry·Herbert C SchulbergBruce L Rollman
Sep 18, 2007·Primary Care·Stephen ThielkeJürgen Unützer
Jul 21, 2015·General Hospital Psychiatry·Scott R BeachJeff C Huffman
Apr 14, 2007·Journal of Psychiatric and Mental Health Nursing·P McEvoy, P Barnes
Jun 9, 2012·International Journal of Geriatric Psychiatry·Donovan T MaustDavid W Oslin
Apr 10, 2015·The Journal of Rural Health : Official Journal of the American Rural Health Association and the National Rural Health Care Association·Dallas WilliamsJürgen Unützer
Dec 19, 2007·The Journal of Continuing Education in the Health Professions·Chandra Kee, Karen M Overstreet
Jun 5, 2013·Journal of Psychosomatic Research·Wayne J Katon, Jürgen Unützer
May 3, 2014·Research on Social Work Practice·Byron J PowellJoseph E Glass
Apr 17, 2018·Journal of the American Geriatrics Society·Christopher M CallahanMalaz A Boustani
Apr 12, 2008·Journal of Occupational and Environmental Medicine·Wayne J Katon, Michelle Seelig
Oct 19, 2012·The Cochrane Database of Systematic Reviews·Janine ArcherPeter Coventry
Sep 2, 2017·Social Work in Health Care·Denise R Black
Jan 7, 2014·Perspectives in Psychiatric Care·Marianne SmithMegan Fang Liu
Sep 11, 2020·Primary Health Care Research & Development·Emily S MillerEydie L Moses-Kolko
Nov 27, 2020·The Journal of Behavioral Health Services & Research·Maria C PromLauren C Ng
Dec 10, 2020·International Journal of Mental Health Systems·C EeJ Sarris
May 22, 2021·Psychiatric Services : a Journal of the American Psychiatric Association·Emily S MillerKatherine L Wisner

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