Evidence map›Paper›PMID 23429924›Full record

Trial reportThe American journal of psychiatry2013

Practice-based versus telemedicine-based collaborative care for depression in rural federally qualified health centers: a pragmatic randomized comparative effectiveness trial.

John C Fortney, Jeffrey M Pyne, Sip B Mouden, Dinesh Mittal, Teresa J Hudson, Gary W Schroeder, David K Williams, Carol A Bynum, Rhonda Mattox, Kathryn M Rost

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The American journal of psychiatry, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 101 papers, 16 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
101citing papers in PubMed, 16 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.

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

101 citing papers in PubMed, 16 syntheses or guidelines pooled it.

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  5. Telemedicine Implementation for Safety Net Populations: A Systematic Review.Telemedicine journal and e-health : the official journal of the American Telemedicine Association · 2024
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  9. Pharmacy-based management for depression in adults.The Cochrane database of systematic reviews · 2019
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  11. Task-Sharing Approaches to Improve Mental Health Care in Rural and Other Low-Resource Settings: A Systematic Review.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2018
    Pooled it
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  14. Telerheumatology: A Systematic Review.Arthritis care & research · 2017
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41 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

John C FortneyDivision of Health Services Research, Department of Psychiatry, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, USA. fortneyjohnc@uams.edu
Jeffrey M Pyne
Sip B Mouden
Dinesh Mittal
Teresa J Hudson
Gary W Schroeder
David K Williams
Carol A Bynum
Rhonda Mattox
Kathryn M Rost

Funding

Telemedicine-Based Collaborative Care to Reduce Rural Health DisparitiesR01MH076908 · NIMH · UNIV OF ARKANSAS FOR MED SCIS · PI FORTNEY, JOHN C. · 2006 to 2010
$2.9M
NIMH NIH HHS MH076908-04S1NIMH NIH HHS R01 MH076908
6 · The paper itself

Abstract

objectivePractice-based collaborative care is a complex evidence-based practice that is difficult to implement in smaller primary care practices that lack on-site mental health staff. Telemedicine-based collaborative care virtually co-locates and integrates mental health providers into primary care settings. The objective of this multisite randomized pragmatic comparative effectiveness trial was to compare the outcomes of patients assigned to practice-based and telemedicine-based collaborative care.

methodFrom 2007 to 2009, patients at federally qualified health centers serving medically underserved populations were screened for depression, and 364 patients who screened positive were enrolled and followed for 18 months. Those assigned to practice-based collaborative care received evidence-based care from an on-site primary care provider and a nurse care manager. Those assigned to telemedicine-based collaborative care received evidence-based care from an on-site primary care provider and an off-site team: a nurse care manager and a pharmacist by telephone, and a psychologist and a psychiatrist via videoconferencing. The primary clinical outcome measures were treatment response, remission, and change in depression severity.

resultsSignificant group main effects were observed for both response (odds ratio=7.74, 95% CI=3.94-15.20) and remission (odds ratio=12.69, 95% CI=4.81-33.46), and a significant overall group-by-time interaction effect was observed for depression severity on the Hopkins Symptom Checklist, with greater reductions in severity over time for patients in the telemedicine-based group. Improvements in outcomes appeared to be attributable to higher fidelity to the collaborative care evidence base in the telemedicine-based group.

conclusionsContracting with an off-site telemedicine-based collaborative care team can yield better outcomes than implementing practice-based collaborative care with locally available staff.

Indexed as

Rural Health ServicesAntidepressive AgentsArkansasDepressionFemaleHumansMaleMedically Underserved AreaMiddle AgedOutcome and Process Assessment, Health CarePatient Care TeamPrimary Health CarePsychiatric Status Rating ScalesPsychotherapyRemission InductionTelemedicineAntidepressive Agents

Identifiers

PMID23429924
PMCPMC3816374

What OpenQuestion holds

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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.