DOES RECRUITMENT METHOD MAKE A DIFFERENCE - EFFECTS ON PROTOCOL RETENTION AND TREATMENT OUTCOME IN ELDERLY DEPRESSED-PATIENTS

The specific aim of this study was to contrast effects of recruitment method (solicited, referred) on demographic, psychosocial, medical, an d treatment outcome measures in an ongoing clinical trial of maintenan ce therapies in late-life depression. Data from 125 elderly patients ( 56 solicited via media campaign, 69 clinically referred) with recurren t, unipolar major depression were available for analysis. Several stat istical contrast procedures, including group t tests, chi(2) tests, su rvival analysis, and logistic regression, were used to assess differen ces in patient profiles related to method of recruitment. Referred pat ients included a higher proportion of African Americans and had a lowe r level of education, fewer economic resources, and higher chronic med ical burden. Solicited patients had been in the index episode longer t han the referred patients at the time of protocol entry and were 3.4 t imes more likely to have experienced a ''provoking agent'' (severe lif e event or chronic difficulty) during the 6 months that preceded the o nset of depressive symptoms. In contrast to these demographic and illn ess history differences, there were no differences in treatment respon se rates or time to response related to recruitment method. Solicited patients had an overall treatment response rate of 71% versus 62% in t he referred group. Median time to response was 14.3 weeks in the solic ited group and 13.6 weeks in the referred group. These results suggest that the inclusion of solicited patients in geriatric depression clin ical trials does not bias short-term treatment outcome.