> |
Researchers at the University
of Pennsylvania School of Medicine have found that
older patients with major depression whose primary care physicians
team with depression care managers are 45% less likely to die
within a 5-year time period. |
> |
The practices were randomly assigned to usual
care, or a depression care management intervention, which involved
a depression care manager who worked with the primary care provider
to recommend treatment for depression according to standard guidelines. Patients
were followed for two years, and approximately 3 years after
the study, death certificates were reviewed to see whether the
depression intervention had any effect on mortality. |
> |
The study appears current issue of the Annals of Internal
Medicine. |
(PHILADELPHIA) – Older patients with major
depression whose
primary care physicians team with depression care managers are
45% less likely to die within a 5-year time period than older adults
with major depression who receive their care in primary care practices
where there are no depression care managers. This study,
conducted by researchers at the University
of Pennsylvania School of Medicine, appears in the current issue of the Annals
of Internal Medicine.
“The results of this study reveal the need for engaging
primary care practices as partners in developing mental health
services for older patients,” says Joseph Gallo,
MD, MPH, Associate Professor of Family
Medicine and Community Health at Penn, and lead author of the paper.
The practice-based, randomized,
controlled trial was conducted
in 20 primary care practices in New York and Pennsylvania. 1,226
randomly sampled patients 60-75 years of age were screened for
depression and were classified as having major
depression (396),
minor depression (203), or no depression (627). The practices
were randomly assigned to usual care, or a depression care management
intervention, which involved a depression care manager who worked
with the primary care provider to recommend treatment for depression
according to standard guidelines. Patients were followed
for two years, and approximately 3 years after the study, death
certificates were reviewed to see whether the depression intervention
had any effect on mortality.
At follow-up, 223 patients had died. Patients with depression
in intervention practices were less likely to have died than those
in usual care practices, and risk of death was reduced in patients
with major depression, but not in patients with minor depression,
or among patients without depression. The benefit seemed
to be almost entirely attributable to a reduction in deaths due
to cancer, and the authors note that the mechanism for the effect
is unclear and warrants further investigation.
This study was funded by the National
Institute of Mental Health.
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