Coordinated Treatment of Depression derly People in Primary Care: A Cluster-Randomized, Controlled Study (GermanIMPACT).
Background: Depression in the elderly is mainly treated by primary care physicians; the treatment is often suboptimal because of the limited resources available in primary care. New models of care in which treatment by a primary care physician is supplemented by the provision of brief, low-threshold...
| Publicado en: | Deutsches Ärzteblatt International Vol. 115; no. 44; pp. 741 - 752 |
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| Autores principales: | , , , , , , , , , , |
| Formato: | Journal Article |
| Publicado: |
Deutscher Aerzte-Verlag GmbH
11/2/2018
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=133748712&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 133748712 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 18660452 5F0N jtl: Deutsches Ärzteblatt International issn: 18660452 maglogo: N pubinfo: dt: 11/2/2018 vid: 115 iid: 44 pid: 25312 pub: Deutscher Aerzte-Verlag GmbH artinfo: ui: 133748712 10.3238/arztebl.2018.0741 133748712 ppf: 741 ppct: 11 formats: fmt: @attributes: type: P tig: atl: Coordinated Treatment of Depression derly People in Primary Care: A Cluster-Randomized, Controlled Study (GermanIMPACT). aug: au: Hölzel, Lars P. Bjerregaard, Frederike Bleich, Christiane Boczor, Sigrid Härter, Martin König, Hans-Helmut Kloppe, Thomas Niebling, Wilhelm Scherer, Martin Tinsel, Iris Hüll, Michael affil: Parkklinik Wiesbaden Schlangenbad, Schlangenbad sug: ab: Background: Depression in the elderly is mainly treated by primary care physicians; the treatment is often suboptimal because of the limited resources available in primary care. New models of care in which treatment by a primary care physician is supplemented by the provision of brief, low-threshold interventions mediated by care managers are showing themselves to be a promising approach. Methods: In this open, cluster-randomized, controlled study, we sought to determine the superiority of a model of this type over the usual form of treatment by a primary care physician. Patients in primary care aged 60 and above with moderate depressive manifestations (PHQ-9: 10-14 points) were included in the study. The primary endpoint was the percentage of patients in remission (score <5 on the Patient Health Questionnaire, PHQ-9) after the end of the intervention (12 months after baseline). The study was registered in the German Clinical Studies Registry (Deutsches Register für Klinische Studien) with the number DRKS00003589. Results: 71 primary care physicians entered 248 patients in the study, of whom 109 were in the control group and 139 in the intervention group. In an intention-to-treat analysis, the remission rate at 12 months was 25.6% (95% confidence interval [18.3; 32.8]) in the intervention group and 10.9% [5.4; 16.5]) in the control group (p = 0.004). Conclusion: This study demonstrates the superiority of the new care model in the primary care setting in Germany, as has been found in other countries. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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