Evidence map›Paper›PMID 21646579›Full record

Trial reportArchives of general psychiatry2011

Collaborative depression care management and disparities in depression treatment and outcomes.

Yuhua Bao, George S Alexopoulos, Lawrence P Casalino, Thomas R Ten Have, Julie M Donohue, Edward P Post, Bruce R Schackman, Martha L Bruce

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Archives of general psychiatry, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00279682 (Prevention of Suicide in Primary Care Elderly), which is not on this map. Cited by 32 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
32citing papers in PubMed, 5 pooled it
–field-weighted citation impact
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.

NCT00279682 phase4completednot on this map

Prevention of Suicide in Primary Care Elderly: Collaborative Trial

TypeinterventionalSponsorWeill Medical College of Cornell UniversityRan1999 to 2003Enrolled1,200ConditionsDepression, Suicide, AttemptedArmstreatment guidelines and depression care management
3 · Its place in the literature

Who cites it

32 citing papers in PubMed, 5 syntheses or guidelines pooled it.

  1. Pooled it
  2. Social inequalities in antidepressant treatment outcomes: a systematic review.Social psychiatry and psychiatric epidemiology · 2020
    Pooled it
  3. Collaborative Care for Psychiatric Disorders in Older Adults: A Systematic Review.Canadian journal of psychiatry. Revue canadienne de psychiatrie · 2017
    Pooled it
  4. Collaborative care for depression and anxiety problems.The Cochrane database of systematic reviews · 2012
    Pooled it
  5. Pooled it
  6. Treatment Adequacy and Adherence as Predictors of Depression Response in Primary Care.The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry · 2020
    Trial
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  14. Centering Culture in Mental Health: Differences in Diagnosis, Treatment, and Access to Care Among Older People of Color.The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry · 2022
    Review
  15. Engaging an Asian Immigrant Older Adult in Depression Care: Collaborative Care, Patient-Provider Communication and Ethnic Identity.The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry · 2021
    Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Yuhua BaoDepartment of Public Health, Weill Cornell Medical College, New York, NY 10065, USA. yub2003@med.cornell.edu
George S Alexopoulos
Lawrence P Casalino
Thomas R Ten Have
Julie M Donohue
Edward P Post
Bruce R Schackman
Martha L Bruce

Funding

University of Pittsburgh Clinical and Translational Science InstitutionKL2RR024154 · NCRR · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI REIS, STEVEN E · 2006 to 2011
$22.2M
TRAINING COREP20MD000182 · NIMHD · CHARLES R. DREW UNIVERSITY OF MED &SCI · PI MARTINS, DAVID SANE, SHAPIRO, MARTIN F. · 2002 to 2016
$16.5M
Research Methods CoreP30MH085943 · NIMH · WEILL MEDICAL COLL OF CORNELL UNIV · PI ALEXOPOULOS, GEORGE S · 2009 to 2013
$9.2M
University of Pittsburgh Clinical and Translational Science InstitutionKL2TR000146 · NCATS · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI REIS, STEVEN E · 2012 to 2015
$8.7M
Insurance Effects on Primary Care for Depressed PatientsK23MH001879 · NIMH · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI POST, EDWARD P · 2001 to 2005
$821k
Designing Payment and Performance Evaluation for Depression Care ManagementK01MH090087 · NIMH · WEILL MEDICAL COLL OF CORNELL UNIV · PI BAO, YUHUA · 2010 to 2014
$782k
Medicare Part D Cost-Sharing and Treatment of Mental Disorders Among Disabled DuaR34MH082682 · NIMH · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI DONOHUE, JULIE MARIE · 2009 to 2010
$379k
NCATS NIH HHS KL2 TR000146NCRR NIH HHS KL2 RR-024154NCRR NIH HHS KL2 RR024154NIMHD NIH HHS P20 MD000182NIMH NIH HHS K01 MH090087NIMH NIH HHS K23 MH001879NIMH NIH HHS K23 MH01879NIMH NIH HHS P30 MH085943NIMH NIH HHS R34 MH082682
6 · The paper itself

Abstract

contextCollaborative depression care management (DCM), by addressing barriers disproportionately affecting patients of racial/ethnic minority and low education, may reduce disparities in depression treatment and outcomes.

objectiveTo examine the effects of DCM on treatment disparities by education and race/ethnicity in older depressed primary care patients.

designAnalysis of data from the randomized controlled trial Prevention of Suicide in Primary Care Elderly: Collaborative Trial (PROSPECT).

settingTwenty primary care practices.

participantsA total of 396 individuals 60 years or older with major depression. We conducted model-based analysis to estimate potentially differential intervention effects by education, independent of those by race/ethnicity (and vice versa).

interventionAlgorithm-based recommendations to physicians and care management by care managers.

main outcome measuresAntidepressant use, depressive symptoms, and intensity of DCM over 2 years.

resultsThe PROSPECT intervention had a larger and more lasting effect in less-educated patients. At month 12, the intervention increased the rate of adequate antidepressant use by 14.2 percentage points (pps) (95% confidence interval [CI], 1.7 to 26.4 pps) in the no-college group compared with a null effect in the college-educated group (-9.2 pps [95% CI, -25.0 to 2.7 pps]); at month 24, the intervention reduced depressive symptoms by 2.6 pps on the Hamilton Depression Rating Scale (95% CI, -4.6 to -0.4 pps) in no-college patients, 3.8 pps (95% CI, -6.8 to -0.4) more than in the college group. The intervention benefitted non-Hispanic white patients more than minority patients. Intensity of DCM received by minorities was 60% to 70% of that received by white patients after the initial phase but did not differ by education.

conclusionsThe PROSPECT intervention substantially reduced disparities by patient education but did not mitigate racial/ethnic disparities in depression treatment and outcomes. Incorporation of culturally tailored strategies in DCM models may be needed to extend their benefits to minorities.

trial registrationclinicaltrials.gov Identifier for PROSPECT: NCT00279682.

Indexed as

Healthcare DisparitiesMental Health ServicesAgedAged, 80 and overAntidepressive AgentsCooperative BehaviorEducational StatusEthnicityFemaleFollow-Up StudiesHumansMajor Depressive DisorderMaleMiddle AgedProspective StudiesTreatment OutcomeAntidepressive Agents

Identifiers

PMID21646579
PMCPMC3522183

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Registered trials

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.