Collaborative care model to improve outcomes in major depression

被引:53
作者
Boudreau, DM
Capoccia, KL
Sullivan, SD
Blough, DK
Ellsworth, AJ
Clark, DL
Katon, WJ
Walker, EA
Stevens, NG
机构
[1] Univ Washington, Dept Pharm, Seattle, WA 98195 USA
[2] Univ Washington, Dept Pharm & Family Med, Seattle, WA 98195 USA
[3] Univ Washington, Dept Hlth Serv, Seattle, WA 98195 USA
[4] Univ Washington, Dept Family Med, Seattle, WA 98195 USA
[5] Kaiser Permanente, Denver, CO USA
[6] Univ Washington, Dept Psychiat, Seattle, WA 98195 USA
关键词
cost-effectiveness; depression; outcomes; primary care;
D O I
10.1345/aph.1A259
中图分类号
R9 [药学];
学科分类号
1007 ;
摘要
Objective: To develop a pharmacist intervention to improve depression care and outcomes within a primary care setting. Methods: Pragmatic, randomized trial of a clinical pharmacist collaborative care intervention versus usual care in a busy, academic family practice clinic. Results: Seventy-four patients diagnosed with a new episode of major depression and started on antidepressant medications were randomized to enhanced care (EC) or usual care (UC) groups. EC consists of a clinical pharmacist collaborating with primary care providers (PCPs) to facilitate education, initiation, and titration of acute-phase antidepressant treatment to monitor treatment adherence and to prevent relapse. Control patients receive LIC by their PCP. The main end point Is reduction of depression symptoms over time as measured by the Hopkins Symptom Checklist (SCL-20). Other outcomes include the Diagnostic and Statistical Manual of Mental Disorders, (DSM-IV) criteria for major depression, health-related quality of life measured by the Medical Outcomes Study Short Form 12 (SF-12), medication adherence, patient satisfaction, and healthcare utilization. The main end point and the cost of treating major depression will be used to estimate the cost-effectiveness of the collaborative care model. Conclusions: The study is a unique, ongoing trial that may have important implications for the treatment of depression in primary care settings as well as new roles for clinical pharmacists.
引用
收藏
页码:585 / 591
页数:7
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