Practice guidelines and late-life depression assessment in long-term care
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
To determine how well nursing home physicians believe they can detect and treat depression, we conducted a national survey, eliciting a 63% response rate. More than 75% of respondents believed they detected and treated depression well. Excellent depression training (vs “good,” “fair,” “poor/none”) was associated with better self-reported recognition (odds ratio [OR] 14.25; 95% confidence interval [CI] 1.81, 111.93) and treatment skills (OR 6.72; 95% CI 1.91, 23.64). Screening tool use predicted greater self-assessed detection (OR 1.89; 95% CI 0.92, 3.87) and treatment competency (OR 2.00; 95% CI 1.14, 3.50). Practice guideline awareness was associated with greater self-reported treatment competency (OR 2.47; 95% CI 1.56, 3.91).
- Parmalee PA, Katz IR, Lawton MP. Depression among institutionalized aged: assessment and prevalence estimation. J Gerontol. 1989;44:M22–9.
- Rovner BW, German PS, Brant C. Depression and mortality in nursing homes. JAMA. 1991;265:993–6. CrossRef
- Fries BE, Mehr DR, Schneider D, Foley WJ, Burke R. Mental dysfunction and resource use in nursing homes. Med Care. 1993;31(10):898–920. CrossRef
- Callahan CM, Hui SL, Nienaber NA, Musick BS, Tierney WM. Longitudinal study of depression and health services use among elderly primary care patients. J Am Geriatr Soc. 1994;42:833–8.
- Heston LL, Garrard J, Makris L, et al. Inadequate treatment of depressed nursing home elderly. J Am Geriatr Soc. 1992;40:1117–22.
- Burns BJ, Wagner HR, Taube JE, Magaziner J, Permutt T, Landerman LR. Mental health service use by the elderly in nursing homes. Am J Public Health. 1993;83(3):331–7. CrossRef
- Callahan CM, Nienaber NA, Hendrie HC, Tierney WM. Depression in elderly outpatients: primary care physicians’ attitudes and practice patterns. J Gen Intern Med. 1992;7(1):26–31. CrossRef
- Banazak DA. Late-life depression in primary care: how well are we doing? J Gen Intern Med. 1996;11(3):163–7. CrossRef
- American Medical Directors Association. Depression: Clinical Practice Guideline. American Medical Directors Association; 1996.
- Main DS, Lutz LJ, Barrett JE, Matthew J, Miller RS. The role of primary care clinician attitudes, beliefs and training in the diagnosis and treatment of depression. Arch Fam Med. 1993;2(8): 1061–6. CrossRef
- Collett D. Modelling Binary Data. New York, NY: Chapman-Hall; 1991.
- Depression Guideline Panel. Depression in Primary Care: Volume 1, Detection and Diagnosis; Volume 2, Treatment of Major Depression. Clinical Practice Guidelines, No. 5. Rockville, Md: US Department of Health and Human Services, Agency for Health Care Policy and Research; 1993:95–6. AHCPR publication 93-0551.
- McFarland BH. Cost-effectiveness considerations for managed care systems: treating depression in primary care. Am J Med. 1994;97(6A):47S-58S. CrossRef
- Gottlieb L, Margolis CZ, Schoenbaum S. Clinical practice guidelines at an HMO: development and implementation in a quality improvement model. Qual Rev Bull. 1990;16:80–6.
- Mulrow CD, Williams JW, Gerety MD. Case-finding instruments for depression in primary care settings. Ann Intern Med. 1995;122:913–21.
- Practice guidelines and late-life depression assessment in long-term care
Journal of General Internal Medicine
Volume 14, Issue 7 , pp 438-440
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- primary care
- nursing home
- Industry Sectors
- Author Affiliations
- 1. Department of Psychiatry, Michigan State University, B-109 West Fee Hall, 48824-1316, East Lansing, MI
- 2. Office of Medical Education Research and Development, Michigan State University, East Lansing, Mich
- 3. Department of Epidemiology, Michigan State University, East Lansing, Mich