Depression Care Management for Depressed Elders in China Primary Care
Status:
Unknown status
Trial end date:
2014-07-01
Target enrollment:
Participant gender:
Summary
Using a randomized controlled design, the investigators will examine whether the DCM is an
effective treatment for patients with late life depression in urban China. Our specific aims
are: (1) to determine whether the DCM intervention results in improved outcomes compared with
CAU at both the provider (e.g., greater adherence to quality indicators) and patient levels
(e.g., greater reduction in depressive symptoms); and (2) to compare DCM with CAU with regard
to a range of outcomes in other pertinent domains, both at the provider (e.g., improvements
in knowledge/attitudes) and patient (e.g., functioning, satisfaction) levels. The study will
take place in 16 primary care clinics (PCCs) randomly assigned to deliver either DCM or CAU
(8 clinics each) to 320 patients (agedā„60 years) with major depression (20/clinic; n=160 in
each treatment condition). In the DCM arm, PCPs will prescribe 16 weeks of antidepressant
medication according to the TG protocol. CMs monitor the progress of treatment and side
effects, educate patients/family, and facilitate communication between providers;
psychiatrists will provide weekly group psychiatric consultation and CM supervision. Patients
in both DCM and CAU arms will be assessed by clinical research coordinators at baseline, 4,
8, 12, 18, and 24 months. HDRS, MMSE, CAS, SF-12, Treatment Stigma and the Client
Satisfaction Questionnaire will be used to assess patients' outcomes; and clinic practices,
attitudes/knowledge, and satisfaction will be providers' outcomes.