December 11, 2002 CHICAGO (AP) -- Elderly patients suffering from depression fared better when there was a team approach to their care, a study suggests.
Researchers found patients had fewer symptoms and greater quality of life when specially trained case managers worked with primary care doctors to help develop treatment plans.
"Just the extra attention, that's what made the big difference," said researcher Dr. Jurgen Unutzer of the Neuropsychiatric Institute at the University of California, Los Angeles, which coordinated the study.
The study in Wednesday's Journal of the American Medical Association followed 1,801 depressed older adults from 18 primary care clinics in California, Indiana, North Carolina, Texas and Washington for one year.
About half of the patients, aged 60 and older, got typical care -- usually a prescription for an anti-depressant. The other half were assigned to a program called Impact, for Improving Mood-Promoting Access to Collaborative Treatment.
The program used specially trained nurses or psychologists as case managers to work with patients. Psychiatrists also consulted on patient care.
After one year, 45 percent of the patients in the Impact program saw a 50 percent or more reduction in depression symptoms, compared with just 19 percent in the other group.
The study is important because it shows that many patients with mild to moderate depression can be treated in a primary-care setting, though specialists still are needed in more severe cases, said Dr. Kenneth Sakauye, chairman of the American Psychiatric Association's Council on Aging. Sakauye was not involved in the research.
He said the team model might work best at an HMO or medical practice that has the resources for a multidisciplinary approach. Unutzer, however, said the model has worked in smaller practices that shared a case manager to follow up on patients.
Copyright 2002 The Associated Press. All rights reserved.
