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QUESTION: Does feedback to physicians or feedback plus telephone care by case managers improve outcomes in patients treated for depression?
Design
Randomised {allocation concealed*}†, blinded (outcome assessors),* controlled trial with follow up at 3 and 6 months.
Setting
5 primary care clinics in Washington State, United States.
Patients
Of 872 eligible patients, 613 (mean age 47 y, 72% women) who had received new prescriptions for antidepressants participated. Exclusion criteria were non-depression indication for antidepressants, bipolar or psychotic disorder in the previous 2 years, alcohol or substance abuse, or a visit to a psychiatrist in the previous 90 days. Follow up was 97% at 3 months and 94% at 6 months.
Intervention
221 patients were allocated to feedback only (a detailed report that included data on antidepressant dosage, repeat prescriptions, number of follow up visits, and limited treatment recommendations based on a computerised algorithm). …
Footnotes
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Source of funding: National Institute of Mental Health.
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For correspondence: Dr G E Simon, Center for Health Studies, Group Health Cooperative, Seattle, WA 98101, USA. Fax +1 206 287 2871.
↵† Information provided by author.