Evidence map›Paper›PMID 19484846›Full record

Trial reportJournal of the American Geriatrics Society2009

Achieving effective antidepressant pharmacotherapy in primary care: the role of depression care management in treating late-life depression.

Yuhua Bao, Edward P Post, Thomas R Ten, Bruce R Schackman, Martha L Bruce

Open access · greenAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of the American Geriatrics Society, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
2.8field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 19 citations in OpenAlex.

  1. Collaborative care for depression and anxiety problems.The Cochrane database of systematic reviews · 2012
    Pooled it
  2. Article
  3. Article
  4. Article
  5. Going beyond antidepressant monotherapy for incomplete response in nonpsychotic late-life depression: a critical review.The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry · 2013
    Review
  6. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors at 1 institution in 1 country.

Yuhua BaoDivision of Health Policy, Department of Public Health, Weill Cornell Medical College, New York, NewYork, USA. yub2003@med.cornell.edu
Edward P Post
Thomas R Ten
Bruce R Schackman
Martha L Bruce
Cornell University · US

Funding

Effectiveness of a Depression Care Management Initiative in Home HealthcareR01MH082425 · NIMH · WEILL MEDICAL COLL OF CORNELL UNIV · PI BRUCE, MARTHA L · 2008 to 2012
$2.8M
PREVENTION OF SUICIDE IN THE ELDERLYR01MH059366 · NIMH · WEILL MEDICAL COLLEGE OF CORNELL UNIV · PI ALEXOPOULOS, GEORGE S · 1998 to 2002
$1.7M
Insurance Effects on Primary Care for Depressed PatientsK23MH001879 · NIMH · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI POST, EDWARD P · 2001 to 2005
$821k
NIMH NIH HHS K23 MH001879NIMH NIH HHS R01 MH059366NIMH NIH HHS R01 MH082425
6 · The paper itself

Abstract

objectivesTo estimate the effect of an evidence-based depression care management (DCM) intervention on the initiation and appropriate use of antidepressant in primary care patients with late-life depression.

designSecondary analysis of data from a randomized trial.

settingCommunity, primary care.

participantsRandomly selected individuals aged 60 and older with routine appointments at 20 primary care clinics randomized to provide a systematic DCM intervention or care as usual.

methodsRates of antidepressant use and dose adequacy of patients in the two study arms were compared at each patient assessment (baseline, 4, 8, and 12 months). For patients without any antidepressant treatment at baseline, a longitudinal analysis was conducted using multilevel logistic models to compare the rate of antidepressant treatment initiation, dose adequacy when initiation was first recorded, and continued therapy for at least 4 months after initiation between study arms. All analyses were conducted for the entire sample and then repeated for the subsample with major or clinically significant minor depression at baseline.

resultsRates of antidepressant use and dose adequacy increased over the first year in patients assigned to the DCM intervention, whereas the same rates held constant in usual care patients. In longitudinal analyses, the DCM intervention had a significant effect on initiation of antidepressant treatment (adjusted odds ratio (OR)=5.63, P<.001) and continuation of antidepressant medication for at least 4 months (OR=6.57, P=.04) for patients who were depressed at baseline.

conclusionsEvidence-based DCM models are highly effective at improving antidepressant treatment in older primary care patients.

Indexed as

Primary Health CareAgedAged, 80 and overAntidepressive AgentsComorbidityDepressive DisorderEvidence-Based MedicineFemaleHumansMaleMiddle AgedTreatment OutcomeAntidepressive Agents

Identifiers

PMID19484846
PMCPMC4520214
OpenAlexW1604065332

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.