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Challenges of Implementing Depression Care Management in the Primary Care Setting

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Abstract

Empirical evidence shows that care management is an effective tool for improving depression treatment in primary care patients. However, several conceptual and practical issues have not been sufficiently addressed. This article explores questions concerning the scope of care management services within the chronic illness care model; optimal ways to identify depressed patients in the primary care setting; responsibilities and desirable qualifications of depression care managers; the location and manner in which care managers interact with patients; costs of services provided by care managers; and the level of supervision by mental health specialists that is necessary to ensure quality care.

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References

  • AHCPR. (1993). Depression in Primary Care. Volume 1: Detection and Diagnosis. Volume 2: Treatment of Major Depression (AHCPR Publication Nos. 93–0550 & 93-0551). Rockville, MD: U.S. Dept. of Health and Human Services, Public Health Service, Agency for Health Care Policy and Research

  • E. Badamgarav, S. Weingarten, J. Henning, K. Knight, V. Hasselblad and A. Gano, Effectiveness of disease management programs in depression: a systematic review. American Journal of Psychiatry 160 (2003) 2080-2090

    Article  PubMed  Google Scholar 

  • M. Bruce, T. Ten Have, C. Reynolds, I. Katz, H. Schulberg and B. Mulsant, Reducing suicidal ideation and depressive symptoms in depressed older primary care patients: a randomized controlled trial. JAMA 291 (2004) 1081-1091

    Article  PubMed  CAS  Google Scholar 

  • S. Gilbody, A. House and T. Sheldon, Routinely administered questionnaires for depression and anxiety: systematic review. British Medical Journal 322 (2001) 406-409

    Article  PubMed  CAS  Google Scholar 

  • H. Goldberg, E. Wagner, S. Fihn, D. Martin, C. Horowitz and D. Christensen, A randomized controlled trial of CQI teams and academic detailing: can they alter compliance with guidelines?. Joint Commission Journal on Quality Improvement 24 (1998) 130-142

    PubMed  CAS  Google Scholar 

  • E. Hunkeler, J. Meresman, W. Hargreaves, B. Fireman, W. Berman and A. Kirsch, Efficacy of nurse telehealth care and peer support in augmenting treatment of depression in primary care. Archives of Family Medicine 9 (2000) 700-708

    Article  PubMed  CAS  Google Scholar 

  • Crossing the Quality Chasm. Washington, D.C.: National Academy Press (2001).

    Google Scholar 

  • W. Katon, P. Robinson, M. VonKorff, E. Lin, T. Bush and E. Ludman, A multifaceted intervention to improve treatment of depression in primary care. Archives of General Psychiatry 53 (1996) 924-932

    PubMed  CAS  Google Scholar 

  • W. Katon, M. VonKorff, E. Lin, E. Walker, G. Simon and T. Bush, Collaborative management to achieve treatment guidelines. Impact on depression in primary care. JAMA 273 (1995) 1026-1031

    Article  PubMed  CAS  Google Scholar 

  • D. Katzelnick, G. Simon, S. Pearson, W. Manning, C. Helstad and H. Henk, Randomized trial of a depression management program in high utilizers of medical care. Archives of Family Medicine 9 (2000) 345-351

    Article  PubMed  CAS  Google Scholar 

  • A. Kilbourne, B. Rollman, H. Schulberg, B. Herbeck Belnap and H. Pincus, A clinical framework for depression treatment in primary care. Psychiatric Annals 32 (2002) 545-535

    Google Scholar 

  • K. Kroenke, R. Spitzer and J. Williams, The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine 16 (2001) 606-613

    Article  PubMed  CAS  Google Scholar 

  • T. Oxman, A. Dietrich and H. Schulberg, The depression care manager and mental health specialist as collaborators within primary care. American Journal of Geriatric Psychiatry 11 (2003) 507-516

    Article  PubMed  Google Scholar 

  • H. Pincus, C. Pechura, L. Elinson and A. Pettit, Depression in primary care: linking clinical and systems strategies. General Hospital Psychiatry 23 (2001) 311-318

    Article  PubMed  CAS  Google Scholar 

  • B. Rollman, B. Hanusa, H. Lowe, T. Gilbert, W. Kapoor and H. Schulberg, A randomized trial using computerized decision support to improve the quality of treatment for major depression in primary care. Journal of General Internal Medicine 17 (2002) 493-503

    Article  PubMed  Google Scholar 

  • B. Rollman, B. Herbeck Belnap, C. Reynolds, H. Schulberg and K. Shear, A contemporary protocol to assist primary care physicians in the treatment of panic and generalized anxiety disorders. General Hospital Psychiatry 25 (2003) 74-82

    Article  PubMed  Google Scholar 

  • K. Rost, P. Nutting, J. Smith and J. Werner, Designing and implementing a primary care intervention trial to improve the quality and outcome of care for major depression. General Hospital Psychiatry 22 (2000) 66-77

    Article  PubMed  CAS  Google Scholar 

  • H. Schulberg, W. Katon, G. Simon and A. Rush, Treating major depression in primary care practice: An update of the Agency for Health Care Policy and Research Practice Guidelines. Archives of General Psychiatry 55 (1998) 1121-1127

    Article  PubMed  CAS  Google Scholar 

  • G. Simon and M. VonKorff, Recognition, management, and outcomes of depression in primary care. Archives of Family Medicine 4 (1995) 99-105

    Article  PubMed  CAS  Google Scholar 

  • G. Simon, M. VonKorff, C. Rutter and E. Wagner, Randomized trial of monitoring, feedback, and management of care by telephone to improve treatment of depression in primary care. British Medical Journal 320 (2000) 550-554

    Article  PubMed  CAS  Google Scholar 

  • J. Unützer, W. Katon, C. Callahan, J. Williams, E. Hunkeler and L. Harpole, Improving mood-promoting access to collaborative treatment. Collaborative care management of late-life depression in the primary care setting: A randomized controlled trial. JAMA 288 (2002) 2836-2845

    Article  Google Scholar 

  • M. Von Korff, J. Gruman, J. Schaefer, S. Curry and E. Wagner, Collaborative management of chronic illness. Annals of Internal Medicine 127 (1997) 1097-1102

    PubMed  CAS  Google Scholar 

  • E. Wagner, B. Austin and M. Von Korff, Organizing care for patients with chronic illness. Milbank Quarterly 74 (1996) 511-544

    Article  PubMed  CAS  Google Scholar 

  • E. Wagner, C. Davis, J. Schaefer, M. Von Korff and B. Austin, A survey of leading chronic disease management programs: Are they consistent with the literature?. Managed Care Quarterly 7 (1999) 56-66

    PubMed  CAS  Google Scholar 

  • K. Wells, M. Schoenbaum, J. Unützer, I. Lagomasino and L. Rubenstein, Quality of care for primary care patients with depression in managed care. Archives of Family Medicine 8 (1999) 529-536

    Article  PubMed  CAS  Google Scholar 

  • K. Wells, C. Sherbourne, M. Schoenbaum, N. Duan, L. Meredith and J. Unützer, Impact of disseminating quality improvement programs for depression in managed primary care: A randomized controlled trial. JAMA 283 (2000) 212-220

    Article  PubMed  CAS  Google Scholar 

  • M. Whooley, B. Stone and K. Soghikian, Randomized trial of case-finding for depression in elderly primary care patients. Journal of General Internal Medicine 15 (2000) 293-300

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Bea Herbeck Belnap.

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Belnap, B.H., Kuebler, J., Upshur, C. et al. Challenges of Implementing Depression Care Management in the Primary Care Setting. Adm Policy Ment Health 33, 65–75 (2006). https://doi.org/10.1007/s10488-005-4237-z

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