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Evid Based Mental Health 6:86 doi:10.1136/ebmh.6.3.86
  • Therapeutics

Collaborative care may improve depression management in older adults


 
 QUESTION: Does collaborative care management improve late life depression?

Design

Randomised trial with allocation concealment. Outcome assessors were blind to treatment allocation.

Setting

18 primary care clinics from 8 healthcare organisations in 5 US states; July 1999—August 2001.

Participants

1801 people aged at least 60 years (mean 71 years) with major depression (17%), dysthymic disorder (30%), or both (53%). 65% were women; 23% were from an ethnic minority. Exclusion criteria were drinking problems; history of psychosis or bipolar disorder; concurrent treatment by psychiatrist; severe cognitive impairment; and acute suicide risk.

Intervention

Improving Mood Promoting Access to Collaborative Treatment (IMPACT) programme (n=906) or usual care (n=895). The IMPACT group received a video and booklet about late life depression and were encouraged to attend …