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A collaborative care management programme in a primary care setting was effective for older adults with late life depression

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 QUESTION: In older adults with late life depression, is a collaborative care management programme offered in a primary care setting effective?

Design

Randomised (allocation concealed)*, blinded (outcome assessors)*, controlled trial with 1 year of follow up.

Setting

18 primary care clinics from 8 healthcare organisations in 5 states in the US.

Patients

1801 patients ≥60 years of age (mean age 71 y, 65% women) who met the DSM-IV criteria for major depression or dysthymia or both and were planning to use general medical care from 1 of the participating clinics. Exclusion criteria were drinking problems, bipolar disorder or psychosis, current treatment by a psychiatrist, severe cognitive impairment, or acute risk of suicide. Follow up was 90%.

Intervention

906 patients were allocated to the Improving Mood-Promoting Access to Collaborative Treatment (IMPACT) management programme, which comprised ≤12 months of access to a depression care …

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