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评估一项抑郁症健康管理计划以改善首次发作或复发抑郁症的治疗效果。

Evaluation of a depression health management program to improve outcomes in first or recurrent episode depression.

作者信息

Aubert Ronald E, Fulop George, Xia Fang, Thiel Melinda, Maldonato Debra, Woo Cindy

机构信息

Medco Health Solutions, Inc., Franklin Lakes, NJ 07417, USA.

出版信息

Am J Manag Care. 2003 May;9(5):374-80.

PMID:12744299
Abstract

OBJECTIVES

To evaluate the impact of telephone counseling and educational materials on medication adherence and persistency among members with newly diagnosed depression enrolled in a pharmacy benefit management-sponsored disease management program.

STUDY DESIGN

Longitudinal cohort observation.

METHODS

The study population comprised 505 members with a new or recurrent episode of depression who consented and enrolled in a depression disease management program. After written consent was obtained, program participants received up to 4 telephone-counseling calls and 5 educational mailings focused on the importance of medication compliance, barriers to medication compliance, quality of life, symptoms, and satisfaction with the program. A control group of 3744 members was selected from client companies that opted not to offer the depression program. Measures of medication adherence, persistency with prescription drug therapy, and patient refill timeliness were computed for both groups and compared.

RESULTS

Patients enrolled in the depression disease management program were significantly more likely to adhere to their medication regimen during acute (89.0% vs 67.7%, P < .001) and continuation treatment phases (81.1% vs 57.6%, P < .001). In addition, members enrolled in the program were significantly more likely to continue their therapy after 7 months (77.8% vs 49.5%, P < .001) and refilled their prescriptions on a more timely basis (0 vs 18 days, P < .001).

CONCLUSIONS

A pharmacy benefit management-sponsored health management depression program succeeded in encouraging patients with new or recurrent depression to stay on antidepressant medication and to reach treatment goals outlined by best practice guidelines.

摘要

目的

评估电话咨询和教育材料对参加药房福利管理机构资助的疾病管理项目的新诊断抑郁症患者用药依从性和持续性的影响。

研究设计

纵向队列观察。

方法

研究人群包括505名同意参加抑郁症疾病管理项目的新发或复发抑郁症患者。获得书面同意后,项目参与者最多接受4次电话咨询和5次教育邮件,内容聚焦于用药依从性的重要性、用药依从性的障碍、生活质量、症状以及对项目的满意度。从选择不提供抑郁症项目的客户公司中选取了3744名成员作为对照组。计算两组的用药依从性、处方药治疗持续性和患者续方及时性指标并进行比较。

结果

参加抑郁症疾病管理项目的患者在急性期(89.0%对67.7%,P<.001)和维持治疗期(81.1%对57.6%,P<.001)更有可能坚持用药方案。此外,参加该项目的成员在7个月后更有可能继续治疗(77.8%对49.5%,P<.001),并且更及时地续方(0天对18天,P<.001)。

结论

药房福利管理机构资助的健康管理抑郁症项目成功鼓励了新发或复发抑郁症患者持续服用抗抑郁药物并实现最佳实践指南规定的治疗目标。

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Evaluation of a depression health management program to improve outcomes in first or recurrent episode depression.评估一项抑郁症健康管理计划以改善首次发作或复发抑郁症的治疗效果。
Am J Manag Care. 2003 May;9(5):374-80.
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Clinician- and organization-level factors in the adoption of evidence-based care for depression in primary care.基层医疗中采用基于证据的抑郁症护理的临床医生和组织层面因素。
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