Variation in the effectiveness of collaborative care for depression: Does it matter where you get your care?

Jürgen Unützer*, Andrew C. Carlo, Robert Arao, Melinda Vredevoogd, John Fortney, Diane Powers, Joan Russo

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

31 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1943-1950
Number of pages8
JournalHealth Affairs
Volume39
Issue number11
DOIs
StatePublished - Nov 2020

ASJC Scopus subject areas

  • Health Policy

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