Health services research · 2017
A Randomized Trial of Off-Site Collaborative Care for Depression in Chronic Hepatitis C Virus.
СтатьяРандомизированное исследованиеПоддержка исследования: вне правительства СШАПоддержка правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Kanwal Fasiha, Pyne Jeffrey M, Tavakoli-Tabasi Shahriar, Nicholson Susan, Dieckgraefe Brian, Storay Erma, Goetz Matthew Bidwell, Kramer Jennifer R, Smith Donna, Sansgiry Shubhada, Tansel Aylin, Gifford Allen L, Asch Steven M
Аннотация
OBJECTIVE: To test the effectiveness of a collaborative depression care model in improving depression and hepatitis C virus (HCV) care.
DATA SOURCES/STUDY SETTING: Hepatitis C virus clinic patients who screened positive for depression at four Veterans Affairs Hospitals.
STUDY DESIGN: We compared off-site depression collaborative care (delivered by depression care manager, pharmacist, and psychiatrist) with usual care in a randomized trial. Primary depression outcomes were treatment response (≥50 percent decrease in 20-item Hopkins Symptoms Checklist [SCL-20] score), remission (mean SCL-20 score, <0.5), and depression-free days (DFDs). Primary HCV outcome was receipt of HCV treatment.
DATA COLLECTION: Patient data were collected by self-report telephone surveys at baseline and 12 months, and from electronic medical records.
PRINCIPAL FINDINGS: Baseline screening identified 292 HCV-infected patients with depression, and 242 patients completed 12-month follow-up (82.9 percent). Intervention participants were more likely to report depression treatment response, remission, and more DFDs than usual care participants. Intervention participants were more likely to receive antiviral treatment; however, the difference was not statistically significant.
CONCLUSION: Off-site depression collaborative care improved depression outcomes in HCV patients and may serve as a model for collaboration between mental health and specialty physical health providers in other high co-occurring conditions.
DATA SOURCES/STUDY SETTING: Hepatitis C virus clinic patients who screened positive for depression at four Veterans Affairs Hospitals.
STUDY DESIGN: We compared off-site depression collaborative care (delivered by depression care manager, pharmacist, and psychiatrist) with usual care in a randomized trial. Primary depression outcomes were treatment response (≥50 percent decrease in 20-item Hopkins Symptoms Checklist [SCL-20] score), remission (mean SCL-20 score, <0.5), and depression-free days (DFDs). Primary HCV outcome was receipt of HCV treatment.
DATA COLLECTION: Patient data were collected by self-report telephone surveys at baseline and 12 months, and from electronic medical records.
PRINCIPAL FINDINGS: Baseline screening identified 292 HCV-infected patients with depression, and 242 patients completed 12-month follow-up (82.9 percent). Intervention participants were more likely to report depression treatment response, remission, and more DFDs than usual care participants. Intervention participants were more likely to receive antiviral treatment; however, the difference was not statistically significant.
CONCLUSION: Off-site depression collaborative care improved depression outcomes in HCV patients and may serve as a model for collaboration between mental health and specialty physical health providers in other high co-occurring conditions.