The authors are with the Montefiore Health System, New York.
Psychiatr Serv. 2018 Nov 1;69(11):1184-1187. doi: 10.1176/appi.ps.201700569. Epub 2018 Aug 28.
The study compared clinical outcomes of depression treatment in primary care with a colocation model versus a collaborative care model (CoCM).
Patients (N=240) with Patient Health Questionnaire-9 (PHQ-9) scores of ≥10 treated for clinically significant depression symptoms in primary care sites implementing the CoCM or a colocation model were compared. PHQ-9 scores were collected at baseline and 12 weeks.
From baseline to follow-up, reductions in PHQ-9 scores were 33% for the CoCM sites and 14% for the colocation sites, with an unadjusted mean difference in scores of 2.81 (p=.001).
More patients treated in sites that used the CoCM experienced a significantly greater reduction in depression symptoms, compared with patients in sites with the colocation model. As greater adoption of integration models in primary care occurs, it will be important to consider potential implications of these results for promoting adoption of CoCM elements. Further replication of these findings is warranted.
本研究比较了在初级保健中采用共置模式与协作式护理模式(CoCM)治疗抑郁症的临床疗效。
在实施 CoCM 或共置模式的初级保健场所中,对 PHQ-9 评分≥10 分的有临床显著抑郁症状的患者(N=240)进行比较。在基线和 12 周时采集 PHQ-9 评分。
从基线到随访,CoCM 组的 PHQ-9 评分降低了 33%,而共置组降低了 14%,评分的未调整平均差异为 2.81(p=.001)。
与共置模式组相比,采用 CoCM 的组中接受治疗的患者抑郁症状明显减轻的比例更高。随着整合模式在初级保健中的更广泛应用,考虑这些结果对促进 CoCM 要素的采用的潜在影响将非常重要。有必要进一步复制这些发现。