Participation in and Impact of a Depression Care Management Program Targeting Low-Income Minority Patients in an Urban Community-Based Clinic
| Autor: | Isabel Alfonsin-Vittoria, Ushimbra J. Buford, Mark Fedders, Erika Arias, Terri Jennings, William Grubb, John G. Ryan |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
Male Low income medicine.medical_specialty Primary care Severity of Illness Index Surveys and Questionnaires Urban Health Services Humans Medicine Pharmacology (medical) Minority Groups Depression (differential diagnoses) Aged Pharmacology African american Depression business.industry Chronic depression Middle Aged Urban community Mental health Primary care clinic Physical therapy Female Patient Participation business |
| Zdroj: | Clinical Therapeutics. 36:778-790 |
| ISSN: | 0149-2918 |
| DOI: | 10.1016/j.clinthera.2014.03.007 |
| Popis: | African American people experience disproportionately higher rates of chronic depression, and among those affected, the condition is less likely to be detected and treated than in non-Hispanic white people.To address this disparity in our primary care clinic, we introduced a validated framework for detecting and managing depression.Over a 5-year period, there were 146 patients diagnosed as having depression and enrolled in a depression care management program. We evaluated the feasibility and effectiveness of that program using baseline and follow-up screening data from the Patient Health Questionnaire-9.The mean baseline severity score of 20.60 was reduced to 15.89 at 6 months (P0.001) and to 16.62 at 12 months. Patients achieved their best score, a mean of 12.93, 10.14 months after baseline (P0.001). The last mean severity score, after 15.47 months, was 14.60, a significant difference compared with baseline (P0.001). Although baseline severity scores for both groups were similar (P = 0.534), patients who remained engaged with the program demonstrated better scores and achieved greater severity score reductions from baseline to the last measure (P0.001). This study did not find any differences between the sexes when comparing PHQ-9 scores at baseline (P = 0.074), 6 months (P = 0.303), and 12 months (P = 0.429) and best (P = 0.875) and last (P = 0.640) scores.Most of the improvement was witnessed in the first 10 months of treatment. Patients with more medical comorbidities participated longer in the study than patients with fewer comorbidities. Further research could elicit the relationship between improvement in mental health and medical conditions. |
| Databáze: | OpenAIRE |
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