Resolving Disparities in Antidepressant Treatment and Quality-of-Life Outcomes Between Uninsured and Insured Primary Care Patients With Depression
Medical CarePublished 1 September 2001
Jeffrey L. Smith, Kathryn Rost, Paul A. Nutting, Carl E. Elliott
Citations32
SJR quartileQ1
SJR score1.57
SNIP1.38
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TL;DR
The intervention improved antidepressant treatment rates in uninsured patients and helped resolve quality-of-life outcome disparities observed between insured and uninsured patients receiving usual care.
Abstract
The intervention improved antidepressant treatment rates in uninsured patients and helped resolve quality-of-life outcome disparities observed between insured and uninsured patients receiving usual care.
Keywords
PsychologyMedicineHealth Professions
The global burden of disease: a comprehensive assessment of mortality and disability from diseases injuries and risk factors in 1990 and projected to 2020.
6,935 Citations1996Christopher J L Murray, Alan D López
Maternal and Child Health JournalHealthy People 2010
4,071 Citations1998Stella M. Yu
These objectives and their associated baseline data and targets for the year 2010 are presented and members of the MCH community are encouraged to review and comment on these objectives during the public comment period.
JAMAThe functioning and well-being of depressed patients. Results from the Medical Outcomes Study
2,524 Citations1989Kenneth B. Wells
PubMedComparison of methods for the scoring and statistical analysis of SF-36 health profile and summary measures: summary of results from the Medical Outcomes Study.
1,744 Citations1995John E. Ware, Mark Kosinski +4 more
Results suggest that the two summary measures may be useful in most studies and that their empiric validity, relative to the best SF-36 scale, will depend on the application.
JAMACollaborative Management to Achieve Treatment Guidelines
1,395 Citations1995Wayne Katon
A multifaceted intervention consisting of collaborative management by the primary care physician and a consulting psychiatrist, intensive patient education, and surveillance of continued refills of antidepressant medication improved adherence to antidepressant regimens in patients with major and with minor depression and resulted in more favorable depressive outcomes.
JAMADepression, Disability Days, and Days Lost From Work in a Prospective Epidemiologic Survey
1,208 Citations1990W E Broadhead
The threshold for identifying clinically significant depression may need to be reevaluated to include persons with fewer symptoms but measurable morbidity, only by changing the nosology can the societal impact of depression be adequately addressed.
JAMAImpact of Disseminating Quality Improvement Programs for Depression in Managed Primary Care
1,033 Citations2000Kenneth B. Wells, Cathy Sherbourne +7 more
When managed primary care practices implemented QI programs that improve opportunities for depression treatment without mandating it, quality of care, mental health outcomes, and retention of employment of depressed patients improved over a year, while medical visits did not increase overall.
Archives of General PsychiatryA Multifaceted Intervention to Improve Treatment of Depression in Primary Care
850 Citations1996Wayne Katon
Archives of General PsychiatryFunctioning and Well-being Outcomes of Patients With Depression Compared With Chronic General Medical Illnesses
848 Citations1995Ron D. Hays
Depressed patients have substantial and long-lasting decrements in multiple domains of functioning and well-being that equal or exceed those of patients with chronic medical illnesses.
General Hospital PsychiatryEpidemiology of depression in primary care
676 Citations1992Wayne Katon, Herbert C. Schulberg
The majority of longitudinal studies have determined that severity of initial depressive symptoms and the presence of a comorbid medical illness were predictors of persistence of depression.
Archives of General PsychiatryStepped Collaborative Care for Primary Care Patients With Persistent Symptoms of Depression
666 Citations1999Wayne Katon, Michael Von Korff +7 more
A multifaceted program targeted to patients whose depressive symptoms persisted 6 to 8 weeks after initiation of antidepressant medication by their primary care physician was found to significantly improve adherence to antidepressants, satisfaction with care, and depressive outcomes compared with usual care.
Archives of General PsychiatryPsychosocial Disability During the Long-term Course of Unipolar Major Depressive Disorder
590 Citations2000Lewis L. Judd, Hagop S. Akiskal +10 more
Depressive symptoms at levels of subthreshold depressive symptoms, minor depression/ dysthymia, and MDD represent a continuum of depressive symptom severity in unipolar MDD, each level of which is associated with a significant stepwise increment in psychosocial disability.
The Journal of Clinical PsychiatrySocial Functioning in Depression
577 Citations2000Robert M. A. Hirschfeld, Stuart Montgomery +10 more
This article reviews the available data on social functioning in depression and provides clinical guidelines and opinion on this important and expanding field and it is becoming clear that not all treatments are equally effective in relieving the impaired social functioning associated with depressive disorders.
Archives of General PsychiatryTreatments of Depression and the Functional Capacity to Work
568 Citations1992Jim Mintz
BMJRandomised trial of monitoring, feedback, and management of care by telephone to improve treatment of depression in primary care
523 Citations2000Gwendal Simon
A programme of systematic follow up and care management by telephone, however, significantly improved outcomes at modest cost.
Medical CareAdequacy and Duration of Antidepressant Treatment in Primary Care
523 Citations1992Wayne Katon, Michael Von Korff +3 more
Analysis of data on the duration of antidepressant therapy for all health maintenance organization enrollees initiating use of antidepressants showed that only 20% of patients who had been given prescriptions for first-generation antidepressants filled four or more prescriptions in the following six months, compared to 34% of Patients who had prescriptions for newer antidepressants.
Archives of Family MedicineRecognition, management, and outcomes of depression in primary care
522 Citations1995Gregory E. Simon
While many depressed primary care patients may go unrecognized and untreated, this group appears to have milder and more self-limited depression.
The LancetEffects of a clinical-practice guideline and practice-based education on detection and outcome of depression in primary care: Hampshire Depression Project randomised controlled trial
492 Citations2000Paul M. Thompson, A‐L Kinmonth +10 more
Although well received, this in-practice programme, designed to convey the current consensus on best practice for the care of depression, did not deliver improvements in recognition of or recovery from depression.
Archives of Family MedicineEfficacy of Nurse Telehealth Care and Peer Support in Augmenting Treatment of Depression in Primary Care
465 Citations2000Enid M. Hunkeler
Nurse telehealth care improves clinical outcomes of antidepressant drug treatment and patient satisfaction and fits well within busy primary care settings, as well as within trained health plan members recovered from depression.
Archives of General PsychiatryTreating Major Depression in Primary Care Practice
433 Citations1996Herbert C. Schulberg
Severity of depressive symptoms was reduced more rapidly and more effectively among patients randomized to pharmacotherapy or psychotherapy than among patients assigned to a physician's usual care.
Medical CareWhat Information Do Consumers Want and How Will They Use It?
399 Citations1995John E. Ware
Long before I entered the field of health policy analysis, I was a methodologist, so methods are important to me when discussing health care information and its uses.
Archives of General PsychiatryRecognition, Management, and Course of Anxiety and Depression in General Practice
386 Citations1991J. Ormel
Among patients who met Bedford College criteria, mean episode durations were longer for anxiety disorders than for depressive disorders, but among the new patients, those with psychiatric disorders recognized by the GP were more likely to receive mental health interventions.
JAMACollaborative management to achieve treatment guidelines. Impact on depression in primary care
375 Citations1995Wayne Katon
Archives of General PsychiatryAnxiety and Depression in a Primary Care Clinic
361 Citations1987Michael Von Korff
Over one half of all persons seen in a primary care clinic were identified as having anxiety or depressive disorder by the primary care provider, the General Health Questionnaire (GHQ), or the Diagnostic Interview Schedule (DIS).
Archives of Internal MedicineDepression in Medical Outpatients
351 Citations1990Eliseo J. Pérez‐Stable
Receiver operating characteristic curves of two self-report depression scales suggest that these scales may assist physicians in recognizing depressed outpatients.
BiostatisticsAssessing the effect of an influenza vaccine in an encouragement design
348 Citations2000Keisuke Hirano, Guido W. Imbens +2 more
An extended framework for the analysis of data from randomized experiments with a binary treatment, binary encouragement, and background covariates is presented, suggesting that global intention-to-treat estimates are too coarse and even misleading when taken as summarizing the evidence in the data for the effects of treatments.
Archives of Family MedicineRandomized Trial of a Depression Management Program in High Utilizers of Medical Care
333 Citations2000David J. Katzelnick
In depressed high utilizers not already in active treatment, a systematic primary care-based treatment program can substantially increase adequate antidepressant treatment, decrease depression severity, and improve general health status compared with usual care.
Archives of Family MedicinePrimary Care Physicians' Approach to Depressive Disorders: Effects of Physician Specialty and Practice Structure
324 Citations1999John W Williams
Quality improvement efforts need to be tailored for different physician specialties, emphasize the importance of differentiating major depression from other depressive disorders and tailoring the treatment approach accordingly, and address organizational barriers to best practice and knowledge gaps about depression treatment.
Journal of the American Geriatrics SocietyImproving Treatment of Late Life Depression in Primary Care: A Randomized Clinical Trial
309 Citations1994Christopher M. Callahan, Hugh C. Hendrie +4 more
Primary care physicians' compliance with recommended standards of care for late life depression by reducing barriers to recognition and treatment is facilitated.
Journal of General Internal MedicineImproving depression outcomes in community primary care practice
293 Citations2001Kathryn Rost, Paul Nutting +3 more
In practices without onsite mental health professionals, brief interventions training primary care teams to assume redefined roles can significantly improve depression outcomes in patients beginning a new treatment episode.
JAMADepression, disability days, and days lost from work in a prospective epidemiologic survey
289 Citations1990W E Broadhead
General Hospital PsychiatryPatterns of antidepressant use in community practice
282 Citations1993Gregory E. Simon, Michael VonKorff +2 more
Analysis of patterns of antidepressant use by primary care physicians and psychiatrists in a large staff-model health maintenance organization suggests more intensive antidepressant treatment than in earlier reports, especially in primary care.
Archives of Family MedicineThe Role of Competing Demands in the Treatment Provided Primary Care Patients With Major Depression
275 Citations2000Kathryn Rost
The attention depression gets during a given medical visit is less associated with the severity of the patient's depressive symptoms than with the number or recency of other problems the patient has.
Medical CareAchieving Guidelines for the Treatment of Depression in Primary Care
236 Citations1997Elizabeth Lin, Wayne Katon +6 more
The results suggest that continuing programs of reorganized service delivery to support the role of a primary care physician (eg, on-site mental health personnel, close monitoring of patient progress and adherence) are essential for the success of guideline implementation.
Archives of General PsychiatryFunctioning and Utility for Current Health of Patients With Depression or Chronic Medical Conditions in Managed, Primary Care Practices
234 Citations1999Kenneth B. Wells, Cathy D. Sherbourne
Primary care patients with depressive conditions have poorer mental, role-emotional, and social functioning than patients with common chronic medical conditions, and physical functioning in the midrange.
American Journal of PsychiatryUse of minor tranquilizers and antidepressant medications by depressed outpatients: results from the medical outcomes study
225 Citations1994Kenneth B. Wells, Wayne Katon +2 more
Use of antidepressant medications among patients of nonphysicians was unrelated to the level of psychological sickness, suggesting the need for more cooperation among provider groups.
General Hospital PsychiatryPersistently poor outcomes of undetected major depression in primary care
191 Citations1998Kathryn Rost, Mingliang Zhang +4 more
Comparison of outcomes with detected patients suggests that quality improvement efforts directed at improving detection without improving management of detected patients may not improve outcomes.
The Joint Commission Journal on Quality ImprovementA Randomized Controlled Trial of CQI Teams and Academic Detailing: Can They Alter Compliance with Guidelines?
183 Citations1998Harold I. Goldberg, Edward H. Wagner +7 more
The AD techniques and the CQI teams evaluated were generally ineffective in improving guideline compliance and clinical outcomes regarding the primary care of hypertension and depression.
Journal of General Internal MedicineRecognition of depression by internists in primary care
141 Citations1989Paul D. Gerber, James E. Barrett +4 more
A comparison of internist and “gold standard” psychiatric assessments of patients was undertaken in a rural primary care practice over a 15-month period to clarify how internists think of “depression” in the primary care context.
Archives of Family MedicineThe 'usual care' of major depression in primary care practice
135 Citations1997Herbert C. Schulberg
The recovery rates for the patients with major depression who were treated with usual care in routine primary care practices were lower than those anticipated from treatments consistent with the Agency for Health Care Policy and Research guidelines.
Archives of Internal MedicineHealth Insurance and Access to Care for Symptomatic Conditions
127 Citations2000David W. Baker, Martin F. Shapiro +1 more
Lack of health insurance is a major barrier to receiving medical care, even for highly serious and morbid symptoms, even though people thought it was needed.
Social Psychiatry and Psychiatric EpidemiologyThe design of Partners in Care: evaluating the cost-effectiveness of improving care for depression in primary care
125 Citations1999Kenneth B. Wells
The result of the study showed that studying treatment effects and quality improvement in nonacademic settings is feasible, but requires relaxation of design features of experiments that protect internal validity.
Psychological MedicineImpact of improved depression treatment in primary care on daily functioning and disability
122 Citations1998Gregory E. Simon, Wayne Katon +8 more
More effective acute-phase depression treatment reduced somatic distress and improved self-rated overall health and the absence of a significant intervention effect on other disability measures may reflect the brief treatment and follow-up period and the influence of other individual and environmental factors on disability.
Psychological MedicineTraining primary-care physicians to recognize, diagnose and manage depression: does it improve patient outcomes?
105 Citations1999Bea Tiemens, Johan Ormel +6 more
Training primary-care physicians to recognize, diagnose and manage depression can improve short-term patient outcomes, especially for patients with a recent onset of depression.
Psychological AssessmentSummed-score linking using item response theory: Application to depression measurement.
103 Citations2000Maria Orlando, Cathy D. Sherbourne +1 more
General Hospital PsychiatryDesigning and implementing a primary care intervention trial to improve the quality and outcome of care for major depression
99 Citations2000Kathryn Rost, Paul A. Nutting +2 more
Early results demonstrate that community primary care practices can rebundle traditional team roles over the short-term to provide more systematic mental health treatment without adding additional personnel.
PubMedEffectiveness of an educational strategy to improve family physicians' detection and management of depression: a randomized controlled trial.
93 Citations1999Graham Worrall, J Angel +3 more
The educational strategy had a modest beneficial effect on the outcomes of patients with depression, but there are still concerns regarding the low rates of drug treatment and referral to mental health professionals by family physicians.
PubMedRecognition of depression by family medicine residents: the impact of screening.
91 Citations1978James T. Moore, Diana R. Silimperi +1 more
A self-administered depression questionnaire was used to alert residents to possible cases of depression, and relay of information from the questionnaire significantly increased resident recognition of depression.
American Journal of PsychiatryThe relationship between insurance coverage and psychiatric disorder in predicting use of mental health services
76 Citations1994Lawrence R. Landerman, B J Burns +3 more
Evidence is provided that failing to provide insurance coverage will reduce utilization as much or more among those with a psychiatric disorder as among those without, which has important implications for health care reform.
PubMedTelephone counseling as an adjunct to antidepressant treatment in the primary care system. A pilot study.
75 Citations2000S. Tutty, Gregory E. Simon +1 more
A telephone counseling and medication monitoring intervention was well accepted by adult patients starting treatment for depression in primary care and seems to significantly improve depression outcomes without affecting the number of visits for treatment of depression.
American Journal of PsychiatryCharacterizing Psychiatry With Findings From the 1996 National Survey of Psychiatric Practice
74 Citations1998Deborah A. Zarin, Harold Alan Pincus +5 more
Findings from the National Survey of Psychiatric Practice will form a baseline for monitoring changes and trends in the delivery and financing of mental health services as psychiatry moves into the next century.
New England Journal of MedicineThe Medically Uninsured — Will They Always Be with Us?
70 Citations1996Steven A. Schroeder
A constant feature of health care in the United States is the authors' national willingness to tolerate having large numbers of people without health insurance.
Journal of Clinical EpidemiologyShort communication
64 Citations1998Kathleen Saunders, Gregory E. Simon +2 more
Self-report and automated data as measures of dose and duration of antidepressant use and treatment adequacy and quality of care as part of a disease management approach to improving care for populations of patients are compared.
PubMedThe value of pharmaceutical representative visits and medication samples in community-based family practices.
58 Citations2000Elisabeth L. Backer, Jason Lebsack +2 more
Clinicians have a complex symbiosis with the pharmaceutical industry and need to critically evaluate their handling of samples and their contact with pharmaceutical representatives to optimize this relationship and ensure quality patient care.
Journal of Health Care for the Poor and UnderservedAccess to Treatment for Depression in a Medicaid Population
53 Citations1999Catherine A. Melfi, Thomas W. Croghan +1 more
It was found that in comparison with Medicaid patients, the privately insured patients who are treated with antidepressants are more likely to receive the newer selective serotonin reuptake inhibitors (SSRIs) rather than the older tricyclic antidepressants (TCAs).
Archives of General PsychiatryMental Health Needs of the Uninsured
52 Citations1991Grayson Norquist
The results indicate that the uninsured have a great potential need for mental health services and that access might be improved through insurance plans such as Medicaid, but further study is needed to determine the adequacy and quality of services provided under Medicaid.
New England Journal of MedicineTrends in Health Care Coverage and Financing and Their Implications for Policy
50 Citations1997Barbara Smith
The nation's preoccupation with the transformation of the health care delivery system to managed care has tended to obscure the importance of a number of other, simultaneous trends, including the declining ability of health care providers to deliver uncompensated care.
PubMedAccess to health care. Part 2: Working-age adults.
39 Citations1997Beth Bloom, Gloria Simpson +2 more
Health insurance plays a key role in the access to medical care services and persons who are uninsured or have low incomes are at the greatest risk of having unmet medical needs.
PubMedHealth insurance may be improving--but not for individuals with mental illness.
36 Citations2000Renea Sturm, Kenneth B. Wells
Substantial activity has taken place in state and federal legislation to increase the mental health benefits offered by health insurance, although this activity could have improved health insurance especially for individuals with mental illness, such persons continue to fare significantly worse than the general population.
PubMedPhysicians helping the underserved: the Reach Out program.
36 Citations2000H. Denman Scott, Johanna Bell +2 more
PubMedAssessment of depression in a family practice center.
34 Citations1987Rosenthal Mp, NI Goldfarb +3 more
The finding that depressive symptoms are highly prevalent in this population supports the need for training physicians in recognition, treatment, and documentation of depression and suggests future research imperatives should include differentiating between depressive symptoms and diagnoses.
The Journal of Rural HealthA Primary Care Intervention for Depression
28 Citations2000Jeffrey I. Smith, Kathryn Rost +3 more
The study's intervention improved the care received by both rural and urban depressed primary care patients and appears to have been greater in rural settings, particularly in terms of increasing depressed rural patients' use of mental health specialists for counseling.
Australian & New Zealand Journal of PsychiatryAn Evaluation of the Effectiveness of a Consultation-Iiaison Psychiatry Service in General Practice
28 Citations1997Vaughan J. Can, Terry J. Lewin +3 more
Questions are raised about the overall benefit of the current consultation-liaison psychiatry service relative to usual GP care and a range of interrelated strategies, including C-L psychiatry services, GP education and well-functioning links with public mental health services are likely to require.
PubMed[Cognitive group therapy].
2 Citations2002Alejandra Pérez, Héctor Fernández Alvarez
This paper presents a brief history of group psychotherapy and it makes a difference between two main kinds of cognitive group therapy: one linked to behavioral approaches and another one more related to postmodern, constructivist and narrative theories.