Premium
PILOT RANDOMIZED TRIAL OF A CROSS‐DIAGNOSIS COLLABORATIVE CARE PROGRAM FOR PATIENTS WITH MOOD DISORDERS
Author(s) -
Kilbourne Amy M.,
Li Decartes,
Lai Zongshan,
Waxmonsky Jeanette,
Ketter Terrence
Publication year - 2013
Publication title -
depression and anxiety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.634
H-Index - 129
eISSN - 1520-6394
pISSN - 1091-4269
DOI - 10.1002/da.22003
Subject(s) - mood , medicine , randomized controlled trial , collaborative care , patient health questionnaire , anxiety , mood disorders , quality of life (healthcare) , coping (psychology) , mental health , psychiatry , depression (economics) , clinical psychology , depressive symptoms , nursing , economics , macroeconomics
Objectives Chronic care models improved outcomes for persons with mental disorders but to date have primarily been tested for single diagnoses (e.g. unipolar depression). We report findings from a pilot multisite randomized controlled trial of a cross‐diagnosis care model for patients with mood disorders. Methods Patients (N = 60) seen in one of four primary care or mental health clinics affiliated with the National Network of Depression Centers were randomized to receive a mood disorder care model, Life Goals Collaborative Care (LGCC, N = 29) or usual care (N = 31). LGCC consisted of five group self‐management sessions focused on mood symptom coping and health behavior change strategies followed by monthly patient and provider care management contacts for up to 6 months. Outcomes at 3 and 6 months included mood symptoms (Patient Health Questionnaire—PHQ‐9, Internal State Scale—well‐being, Generalized Anxiety Disorder scale) and health‐related quality of life . Results Of the 60 enrolled, the mean age was 46.2 (SD = 13.2), 73.3% were female, 16.7% were non‐white, and 36.8% had a bipolar disorder diagnosis. LGCC was associated with greater likelihood of depressive symptom remission in 6 months (respectively, 50% versus 19% had a PHQ‐9 score ≤9 and 50% reduction in PHQ‐9 score, P = .04) and improved well‐being (β = 2.66, P ≤ .01, Cohen's D = 0.43) . Conclusions LGCC may improve outcomes for patients regardless of mood diagnosis, potentially providing a feasible and generalizable chronic care model for routine practice settings .