Progress on Primary Care Management of Depression

Editorials15 September 2009Progress on Primary Care Management of DepressionAllen J. Dietrich, MDAllen J. Dietrich, MDFrom Dartmouth Medical School, Hanover, NH 03755.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-151-6-200909150-00008 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail In this issue, a report from Germany provides important guidance for primary care clinicians and policymakers. Working with 74 small primary care practices in a cluster randomized trial, Gensichen and colleagues (1) found that provision of telephone support by practice staff to patients with depression improved 12-month depression outcomes. At baseline, 75% of patients were already in treatment (others were identified through screening) and symptoms were moderately severe, with Patient Health Questionnaire-9 (PHQ-9) scores of 17 (2). At 12 months, depression severity scores showed moderate but significantly greater improvement for the intervention group than for the control group (intervention recipients ...References1. Gensichen J, von Korff M, Peitz M, Muth C, Beyer M, Güthlin C, et al. Case management for depression by health care assistants in small primary care practices. A cluster randomized trial. Ann Intern Med. 2009;151:369-78. LinkGoogle Scholar2. Spitzer RL, Kroenke K, Williams JB. Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary Care Evaluation of Mental Disorders. Patient Health Questionnaire. JAMA. 1999;282:1737-44. [PMID: 10568646] CrossrefMedlineGoogle Scholar3. Ustün TB, Ayuso-Mateos JL, Chatterji S, Mathers C, Murray CJ. Global burden of depressive disorders in the year 2000. Br J Psychiatry. 2004;184:386-92. [PMID: 15123501] CrossrefMedlineGoogle Scholar4. Stewart WF, Ricci JA, Chee E, Hahn SR, Morganstein D. 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I S. 2477, § 73b Hausarztzentrierte Versorgung [general practice-centered care]. Google Scholar16. German Medical Association. Curriculum Health Care Assistants: “Patient support and co-ordination.”. Berlin, Germany: German Med Assoc; 2007. Google Scholar17. Bodenheimer T, Grumbach K, Berenson RA. A lifeline for primary care. N Engl J Med. 2009;360:2693-6. [PMID: 19553643] CrossrefMedlineGoogle Scholar18. Sack K. Mass. panel backs radical shift in health payment. New York Times. 16 July 2009. Google Scholar19. Patient-Centered Primary Care Collaborative. Joint Principles of the Patient-Centered Medical Home. Washington, DC: Patient-Centered Primary Care Collaborative; 2007. Accessed at www.pcpcc.net/content/joint-principles-patient-centered-medical-home on 6 August 2009. Google Scholar Author, Article, and Disclosure InformationAuthors: Allen J. Dietrich, MDAffiliations: From Dartmouth Medical School, Hanover, NH 03755.Disclosures:Consultancies: Dr. Dietrich is 1 of 2 principals in 3CM, LLC, a consulting firm that provides consultation services to health care organizations in the United States, including the Department of Defense, the City of New York, the Veterans Administration, and various insurance plans. Grants received: MacArthur Initiative on Depression and Primary Care.Corresponding Author: Allen J. Dietrich, MD, Dartmouth Hitchcock Medical Center, 1 Medical Center Drive, Rubin 833, Lebanon, NH 03756. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoCase Management for Depression by Health Care Assistants in Small Primary Care Practices Jochen Gensichen , Michael von Korff , Monika Peitz , Christiane Muth , Martin Beyer , Corina Güthlin , Marion Torge , Juliana J. Petersen , Thomas Rosemann , Jochem König , and Ferdinand M. Gerlach , for PRoMPT (PRimary care Monitoring for depressive Patients Trial) Metrics Cited bySuicide prevention in military organizations 15 September 2009Volume 151, Issue 6Page: 425-426KeywordsHealth careHealth care policy reportsHealth services administration and managementPatientsPrimary carePsychiatry and mental healthQuality improvementQuality of lifeRandomized trialsVeteran care ePublished: 15 September 2009 Issue Published: 15 September 2009 Copyright & PermissionsCopyright © 2009 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...