TY - JOUR
T1 - Variation in the effectiveness of collaborative care for depression
T2 - Does it matter where you get your care?
AU - Unützer, Jürgen
AU - Carlo, Andrew C.
AU - Arao, Robert
AU - Vredevoogd, Melinda
AU - Fortney, John
AU - Powers, Diane
AU - Russo, Joan
N1 - Publisher Copyright:
© 2020 Project HOPE— The People-to-People Health Foundation, Inc.
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/11
Y1 - 2020/11
N2 - Randomized controlled trials have demonstrated that the collaborative care model for depression in primary care is more effective than usual care, but little is known about the effectiveness of this approach in real-world settings. We used patient-reported outcome data from 11,303 patients receiving collaborative care for depression in 135 primary care clinics to examine variations in depression outcomes. The average treatment response across this large sample of clinics was substantially lower than response rates reported in randomized controlled trials, and substantial outcome variation was observed. Patient factors such as initial depression severity, clinic factors such as the number of years of collaborative care practice, and the degree of implementation support received were associated with depression outcomes at follow-up. Our findings suggest that the level of implementation support could be an important influence on the effectiveness of collaborative care model programs.
AB - Randomized controlled trials have demonstrated that the collaborative care model for depression in primary care is more effective than usual care, but little is known about the effectiveness of this approach in real-world settings. We used patient-reported outcome data from 11,303 patients receiving collaborative care for depression in 135 primary care clinics to examine variations in depression outcomes. The average treatment response across this large sample of clinics was substantially lower than response rates reported in randomized controlled trials, and substantial outcome variation was observed. Patient factors such as initial depression severity, clinic factors such as the number of years of collaborative care practice, and the degree of implementation support received were associated with depression outcomes at follow-up. Our findings suggest that the level of implementation support could be an important influence on the effectiveness of collaborative care model programs.
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U2 - 10.1377/hlthaff.2019.01714
DO - 10.1377/hlthaff.2019.01714
M3 - Article
C2 - 33136506
AN - SCOPUS:85095402471
VL - 39
SP - 1943
EP - 1950
JO - Health affairs (Project Hope)
JF - Health affairs (Project Hope)
SN - 0278-2715
IS - 11
ER -