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Treating Depressed Older Adults in Primary Care: Narrowing the Gap between Efficacy and Effectiveness
Author(s) -
Unützer Jürgen,
Katon Wayne,
Sullivan Mark,
Miranda Jeanne
Publication year - 1999
Publication title -
the milbank quarterly
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 101
eISSN - 1468-0009
pISSN - 0887-378X
DOI - 10.1111/1468-0009.00132
Subject(s) - depression (economics) , primary care , late life depression , psychological intervention , medicine , social isolation , management of depression , disease , gerontology , population , psychiatry , psychology , family medicine , cognition , environmental health , pathology , economics , macroeconomics
There is a gap between the efficacy of treatments for late‐life depression under research conditions and the effectiveness of treatments as they occur in the “real world” of primary care. Considerable evidence supports the efficacy of treatments for late‐life depression, but many depressed older adults either are not recognized or do not receive effective treatment for depression in primary care. Older adults face a range of special treatment barriers: knowledge deficits; losses and social isolation; multiple medical problems; and lack of financial resources. More research is needed to understand these barriers and to study the effectiveness of multifaceted, population‐based disease management interventions for late‐life depression in primary care.