Home > Publications . Search All . Browse All . Country . Browse PSC Pubs . PSC Report Series

PSC In The News

RSS Feed icon

Stephenson assessing in-home HIV testing and counseling for male couples

Thompson says mass incarceration causes collapse of Detroit neighborhoods

Liberal-conservative gap by education level growing in U.S.

Highlights

Maggie Levenstein named director of ISR's Inter-university Consortium for Political and Social Research

Arline Geronimus receives 2016 Harold R. Johnson Diversity Service Award

PSC spring 2016 newsletter: Kristin Seefeldt, Brady West, newly funded projects, ISR Runs for Bob, and more

AAUP reports on faculty compensation by category, affiliation, and academic rank

Next Brown Bag

PSC Brown Bags
will resume fall 2016

Five-Year Impact of Quality Improvement for Depression - Results of a Group-Level Randomized Controlled Trial

Archived Abstract of Former PSC Researcher

Wells, K., C. Sherbourne, Michael Schoenbaum, S. Ettner, N. Duan, J. Miranda, J. Unutzer, and L. Rubenstein. 2004. "Five-Year Impact of Quality Improvement for Depression - Results of a Group-Level Randomized Controlled Trial." Archives of General Psychiatry, 61(4): 378-386.

Background: Quality improvement (QI) programs for depressed primary care patients can improve health outcomes for 6 to 28 months; effects for longer than 28 months are unknown. Objective: To assess how QI for depression affects health outcomes, quality of care, and health outcome disparities at 57-month follow-up. Design: A group-level randomized controlled trial. Setting: Forty-six primary care practices in 6 managed care organizations. Patients: Of 1356 primary care patients who screened positive for depression and enrolled in the trial, 991 (73%, including 451 Latinos and African Americans) completed 57-month telephone follow-up. Interventions: Clinics were randomly assigned to usual care or to I of 2 QI programs supporting QI teams, provider training, nurse assessment, and patient education, plus resources to support medication management (QI-meds) or psychotherapy (QI-therapy) for 6 to 12 months. Main Outcome Measures: Probable depressive disorder in the previous 6 months, mental health-related quality of life in the previous 30 days, primary care or mental health specialty visits, counseling or antidepressant medications in the previous 6 months, and unmet need, defined as depressed but not receiving appropriate care. Results: Combined QI-meds and QI-therapy, relative to usual care, reduced the percentage of participants with probable disorder at 5 years by 6.6 percentage points (P=.04). QI-therapy improved health outcomes and reduced unmet need for appropriate care among Latinos and African Americans combined but provided few long-term benefits among whites, reducing outcome disparities related to usual care (P=.04 for QI-ethnicity interaction for probable depressive disorder). Conclusions: Programs for QI for depressed primary care patients implemented by managed care practices can improve health outcomes 5 years after implementation and reduce health outcome disparities by markedly improving health outcomes and unmet need for appropriate care among Latinos and African Americans relative to whites; thus, equity was improved in the long run.

Browse | Search : All Pubs | Next