A MULTIFACETED INTERVENTION TO IMPROVE TREATMENT OF DEPRESSION IN PRIMARY-CARE

Background: This research study evaluates the effectiveness of a multi faceted intervention program to improve the management of depression i n primary care. Methods: One hundred fifty-three primary care patients with current depression were entered into a randomized controlled tri al. Intervention patients received a structured depression treatment p rogram in the primary care setting that included both behavioral treat ment to increase use of adaptive coping strategies and counseling to i mprove medication adherence. Control patients received ''usual'' care by their primary care physicians. Outcome measures included adherence to antidepressant medication, satisfaction with care of depression and with antidepressant treatment, and reduction of depressive symptoms o ver time. Results: At 4-month follow-up, significantly more interventi on patients with major and minor depression than usual care patients a dhered to antidepressant medication and rated the quality of care they received for depression as good to excellent. Intervention patients w ith major depression demonstrated a significantly greater decrease in depression severity over time compared with usual care patients on all 4 outcome analyses. Intervention patients with minor depression were found to have a significant decrease over time in depression severity on only 1 of 4 study outcome analyses compared with usual care patient s, Conclusion: A multifaceted primary care intervention improved adher ence to antidepressant regimens and satisfaction with care in patients with major and minor depression. The intervention consistently result ed in more favorable depression outcomes among patients with major dep ression, while outcome effects were ambiguous among patients with mino r depression.