Tuesday, August 25, 2015

Outreach Care Management, Self-Management Improves Outcomes for Patients With Depression

A program that combined outreach care management and self-management skills for people with chronic or recurrent depressive symptoms was more effective than treatment as usual in reducing depressive symptoms and major depressive episodes, according to a study published last week in Psychiatric Services in Advance.

Researchers from the Group Health Research Institute in Seattle recruited 302 participants ages 18 and older with chronic depression or recurrent episodes of depression from five primary care clinics in the Seattle area. Participants were randomly assigned to treatment as usual or a self-management support service consisting of depression self-management training, recovery coaching, and care coordination.

The 18-month intervention included regular telephone or in-person contacts with a care manager and a structured group program. As part of the group program, participants met weekly for ten weeks, twice a month for two months, and then once a month for maintenance of progress. The meetings were co-led by a care manager and a trained peer specialist.

Repeated-measures estimates of the long-term effect of the intervention versus usual care (average of the six-, 12-, and 18-month outcomes adjusted for age, gender, and site) indicated that intervention participants had less severe symptoms, higher recovery scores, and were less likely to be depressed.

“A systematic program of care management and group self-management support is a worthy addition to outpatient care for patients with chronic depressive symptoms,” the study authors wrote. “By combining elements of the chronic care model and the recovery model in a single program, the program successfully integrated the management strengths of the chronic care model with the sense of optimism and well-being provided by a care management approach.”

For related information, see the Psychiatric News article “Integrated Care Book Offers ‘How-To’ Advice for Psychiatrists.

(Image: Monkey Business Images/Shutterstock)


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