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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 …
Footnotes
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Sources of funding: John A Hartford Foundation; Hogg Foundation; California Healthcare Foundation; Robert Wood Johnson Foundation.
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For correspondence: Dr J Unützer, Center for Health Services Research, UCLA Neuropsychiatric Institute, Los Angeles, CA, USA. unutzer{at}ucla.edu
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A modified version of this abstract appears in Evidence-Based Nursing.