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Q Does decision support for primary care clinicians improve outcomes for people with depression?
Cluster randomised controlled trial (clinicians randomised).
Single blind (assessors blinded).
Three urban and two rural primary care clinics at a Veterans Affairs Medical Centre, USA; recruitment July 2002 to October 2003.
Forty one primary care clinicians were randomised and all their patients with moderate to severe depression (Patient Health Questionnaire (PHQ-9) score between 10 and 25 or Hopkins Symptom Checklist 20 (SCL-20) score >1) were eligible for inclusion. 375 patients met inclusion criteria and enrolled. Patient exclusions: very severe depression (PHQ-9 score >9); active dangerous ideation; psychotic disorder; dementia; bipolar disorder; treated by mental health specialist in preceding 6 months; or terminally ill.
Depression decision support or usual care. Depression decision support: team including one nurse care manager and one psychiatrist. Care manager contacted the patient once by telephone after initial diagnosis to …
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