ArticleJournal of the American Board of Family Medicine : JABFM
Treatment Differences in Primary and Specialty Settings in Veterans with Major Depression.
Open access · diamondAbstract read
In one paragraph
Article in Journal of the American Board of Family Medicine : JABFM. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.8field-weighted citation impact, top 16% of its field
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.
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.
Who cites it
3 citing papers in PubMed, 9 citations in OpenAlex.
- Development of a model to predict antidepressant treatment response for depression among Veterans.Psychological medicine · 2023Article
- Development of a model to predict combined antidepressant medication and psychotherapy treatment response for depression among veterans.Journal of affective disorders · 2023Article
- Are Veterans Getting Their Preferred Depression Treatment? A National Observational Study in the Veterans Health Administration.Journal of general internal medicine · 2022Observational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 8 institutions in 1 country.
Victor Puac-PolancoFrom the Department of Health Care Policy, Harvard Medical School, Boston, MA (VP-P, HL, HNZ, RCK); the Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY (VP-P); the Center for the Study of Healthcare Innovation, Implementation, and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA (LBL); the Division of General Internal Medicine, and Health Services Research, UCLA David Geffen School of Medicine, Los Angeles, CA (LBL); the Department of Behavioral Medicine and Psychiatry, West Virginia University, Morgantown, (RMB); the Center of Excellence for Suicide Prevention, Canandaigua VAMC, Canandaigua, NY (RMB, HL, WRP); the VA Ann Arbor, Center for Clinical Management Research, Ann Arbor, MI (CB, JNK, EPP); the Department of Psychiatry, University of Rochester Medical Center, Rochester, NY (WRP); the Department of Medicine, University of Michigan Medical School, Ann Arbor (EPP); the Cpl Michael J Crescenz VA Medical Center, VISN 4 Mental Illness Research Education and Clinical Center, Philadelphia, PA (DWO); the Perelman School of Medicine, University of Pennsylvania, Philadelphia (DWO).
Lucinda B LeungFrom the Department of Health Care Policy, Harvard Medical School, Boston, MA (VP-P, HL, HNZ, RCK); the Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY (VP-P); the Center for the Study of Healthcare Innovation, Implementation, and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA (LBL); the Division of General Internal Medicine, and Health Services Research, UCLA David Geffen School of Medicine, Los Angeles, CA (LBL); the Department of Behavioral Medicine and Psychiatry, West Virginia University, Morgantown, (RMB); the Center of Excellence for Suicide Prevention, Canandaigua VAMC, Canandaigua, NY (RMB, HL, WRP); the VA Ann Arbor, Center for Clinical Management Research, Ann Arbor, MI (CB, JNK, EPP); the Department of Psychiatry, University of Rochester Medical Center, Rochester, NY (WRP); the Department of Medicine, University of Michigan Medical School, Ann Arbor (EPP); the Cpl Michael J Crescenz VA Medical Center, VISN 4 Mental Illness Research Education and Clinical Center, Philadelphia, PA (DWO); the Perelman School of Medicine, University of Pennsylvania, Philadelphia (DWO).
Robert M BossarteFrom the Department of Health Care Policy, Harvard Medical School, Boston, MA (VP-P, HL, HNZ, RCK); the Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY (VP-P); the Center for the Study of Healthcare Innovation, Implementation, and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA (LBL); the Division of General Internal Medicine, and Health Services Research, UCLA David Geffen School of Medicine, Los Angeles, CA (LBL); the Department of Behavioral Medicine and Psychiatry, West Virginia University, Morgantown, (RMB); the Center of Excellence for Suicide Prevention, Canandaigua VAMC, Canandaigua, NY (RMB, HL, WRP); the VA Ann Arbor, Center for Clinical Management Research, Ann Arbor, MI (CB, JNK, EPP); the Department of Psychiatry, University of Rochester Medical Center, Rochester, NY (WRP); the Department of Medicine, University of Michigan Medical School, Ann Arbor (EPP); the Cpl Michael J Crescenz VA Medical Center, VISN 4 Mental Illness Research Education and Clinical Center, Philadelphia, PA (DWO); the Perelman School of Medicine, University of Pennsylvania, Philadelphia (DWO).
Corey BryantFrom the Department of Health Care Policy, Harvard Medical School, Boston, MA (VP-P, HL, HNZ, RCK); the Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY (VP-P); the Center for the Study of Healthcare Innovation, Implementation, and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA (LBL); the Division of General Internal Medicine, and Health Services Research, UCLA David Geffen School of Medicine, Los Angeles, CA (LBL); the Department of Behavioral Medicine and Psychiatry, West Virginia University, Morgantown, (RMB); the Center of Excellence for Suicide Prevention, Canandaigua VAMC, Canandaigua, NY (RMB, HL, WRP); the VA Ann Arbor, Center for Clinical Management Research, Ann Arbor, MI (CB, JNK, EPP); the Department of Psychiatry, University of Rochester Medical Center, Rochester, NY (WRP); the Department of Medicine, University of Michigan Medical School, Ann Arbor (EPP); the Cpl Michael J Crescenz VA Medical Center, VISN 4 Mental Illness Research Education and Clinical Center, Philadelphia, PA (DWO); the Perelman School of Medicine, University of Pennsylvania, Philadelphia (DWO).
Janelle N KeuschFrom the Department of Health Care Policy, Harvard Medical School, Boston, MA (VP-P, HL, HNZ, RCK); the Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY (VP-P); the Center for the Study of Healthcare Innovation, Implementation, and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA (LBL); the Division of General Internal Medicine, and Health Services Research, UCLA David Geffen School of Medicine, Los Angeles, CA (LBL); the Department of Behavioral Medicine and Psychiatry, West Virginia University, Morgantown, (RMB); the Center of Excellence for Suicide Prevention, Canandaigua VAMC, Canandaigua, NY (RMB, HL, WRP); the VA Ann Arbor, Center for Clinical Management Research, Ann Arbor, MI (CB, JNK, EPP); the Department of Psychiatry, University of Rochester Medical Center, Rochester, NY (WRP); the Department of Medicine, University of Michigan Medical School, Ann Arbor (EPP); the Cpl Michael J Crescenz VA Medical Center, VISN 4 Mental Illness Research Education and Clinical Center, Philadelphia, PA (DWO); the Perelman School of Medicine, University of Pennsylvania, Philadelphia (DWO).
Howard LiuFrom the Department of Health Care Policy, Harvard Medical School, Boston, MA (VP-P, HL, HNZ, RCK); the Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY (VP-P); the Center for the Study of Healthcare Innovation, Implementation, and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA (LBL); the Division of General Internal Medicine, and Health Services Research, UCLA David Geffen School of Medicine, Los Angeles, CA (LBL); the Department of Behavioral Medicine and Psychiatry, West Virginia University, Morgantown, (RMB); the Center of Excellence for Suicide Prevention, Canandaigua VAMC, Canandaigua, NY (RMB, HL, WRP); the VA Ann Arbor, Center for Clinical Management Research, Ann Arbor, MI (CB, JNK, EPP); the Department of Psychiatry, University of Rochester Medical Center, Rochester, NY (WRP); the Department of Medicine, University of Michigan Medical School, Ann Arbor (EPP); the Cpl Michael J Crescenz VA Medical Center, VISN 4 Mental Illness Research Education and Clinical Center, Philadelphia, PA (DWO); the Perelman School of Medicine, University of Pennsylvania, Philadelphia (DWO).
Hannah N ZiobrowskiFrom the Department of Health Care Policy, Harvard Medical School, Boston, MA (VP-P, HL, HNZ, RCK); the Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY (VP-P); the Center for the Study of Healthcare Innovation, Implementation, and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA (LBL); the Division of General Internal Medicine, and Health Services Research, UCLA David Geffen School of Medicine, Los Angeles, CA (LBL); the Department of Behavioral Medicine and Psychiatry, West Virginia University, Morgantown, (RMB); the Center of Excellence for Suicide Prevention, Canandaigua VAMC, Canandaigua, NY (RMB, HL, WRP); the VA Ann Arbor, Center for Clinical Management Research, Ann Arbor, MI (CB, JNK, EPP); the Department of Psychiatry, University of Rochester Medical Center, Rochester, NY (WRP); the Department of Medicine, University of Michigan Medical School, Ann Arbor (EPP); the Cpl Michael J Crescenz VA Medical Center, VISN 4 Mental Illness Research Education and Clinical Center, Philadelphia, PA (DWO); the Perelman School of Medicine, University of Pennsylvania, Philadelphia (DWO).
Wilfred R PigeonFrom the Department of Health Care Policy, Harvard Medical School, Boston, MA (VP-P, HL, HNZ, RCK); the Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY (VP-P); the Center for the Study of Healthcare Innovation, Implementation, and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA (LBL); the Division of General Internal Medicine, and Health Services Research, UCLA David Geffen School of Medicine, Los Angeles, CA (LBL); the Department of Behavioral Medicine and Psychiatry, West Virginia University, Morgantown, (RMB); the Center of Excellence for Suicide Prevention, Canandaigua VAMC, Canandaigua, NY (RMB, HL, WRP); the VA Ann Arbor, Center for Clinical Management Research, Ann Arbor, MI (CB, JNK, EPP); the Department of Psychiatry, University of Rochester Medical Center, Rochester, NY (WRP); the Department of Medicine, University of Michigan Medical School, Ann Arbor (EPP); the Cpl Michael J Crescenz VA Medical Center, VISN 4 Mental Illness Research Education and Clinical Center, Philadelphia, PA (DWO); the Perelman School of Medicine, University of Pennsylvania, Philadelphia (DWO).
David W OslinFrom the Department of Health Care Policy, Harvard Medical School, Boston, MA (VP-P, HL, HNZ, RCK); the Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY (VP-P); the Center for the Study of Healthcare Innovation, Implementation, and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA (LBL); the Division of General Internal Medicine, and Health Services Research, UCLA David Geffen School of Medicine, Los Angeles, CA (LBL); the Department of Behavioral Medicine and Psychiatry, West Virginia University, Morgantown, (RMB); the Center of Excellence for Suicide Prevention, Canandaigua VAMC, Canandaigua, NY (RMB, HL, WRP); the VA Ann Arbor, Center for Clinical Management Research, Ann Arbor, MI (CB, JNK, EPP); the Department of Psychiatry, University of Rochester Medical Center, Rochester, NY (WRP); the Department of Medicine, University of Michigan Medical School, Ann Arbor (EPP); the Cpl Michael J Crescenz VA Medical Center, VISN 4 Mental Illness Research Education and Clinical Center, Philadelphia, PA (DWO); the Perelman School of Medicine, University of Pennsylvania, Philadelphia (DWO).
Edward P PostFrom the Department of Health Care Policy, Harvard Medical School, Boston, MA (VP-P, HL, HNZ, RCK); the Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY (VP-P); the Center for the Study of Healthcare Innovation, Implementation, and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA (LBL); the Division of General Internal Medicine, and Health Services Research, UCLA David Geffen School of Medicine, Los Angeles, CA (LBL); the Department of Behavioral Medicine and Psychiatry, West Virginia University, Morgantown, (RMB); the Center of Excellence for Suicide Prevention, Canandaigua VAMC, Canandaigua, NY (RMB, HL, WRP); the VA Ann Arbor, Center for Clinical Management Research, Ann Arbor, MI (CB, JNK, EPP); the Department of Psychiatry, University of Rochester Medical Center, Rochester, NY (WRP); the Department of Medicine, University of Michigan Medical School, Ann Arbor (EPP); the Cpl Michael J Crescenz VA Medical Center, VISN 4 Mental Illness Research Education and Clinical Center, Philadelphia, PA (DWO); the Perelman School of Medicine, University of Pennsylvania, Philadelphia (DWO).
Ronald C KesslerFrom the Department of Health Care Policy, Harvard Medical School, Boston, MA (VP-P, HL, HNZ, RCK); the Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY (VP-P); the Center for the Study of Healthcare Innovation, Implementation, and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA (LBL); the Division of General Internal Medicine, and Health Services Research, UCLA David Geffen School of Medicine, Los Angeles, CA (LBL); the Department of Behavioral Medicine and Psychiatry, West Virginia University, Morgantown, (RMB); the Center of Excellence for Suicide Prevention, Canandaigua VAMC, Canandaigua, NY (RMB, HL, WRP); the VA Ann Arbor, Center for Clinical Management Research, Ann Arbor, MI (CB, JNK, EPP); the Department of Psychiatry, University of Rochester Medical Center, Rochester, NY (WRP); the Department of Medicine, University of Michigan Medical School, Ann Arbor (EPP); the Cpl Michael J Crescenz VA Medical Center, VISN 4 Mental Illness Research Education and Clinical Center, Philadelphia, PA (DWO); the Perelman School of Medicine, University of Pennsylvania, Philadelphia (DWO). kessler@hcp.med.harvard.edu.
Canandaigua VA Medical Center · USColumbia University · USVA Healthcare-VISN 4 · USHarvard University · USPhiladelphia VA Medical Center · USUniversity of Rochester Medical Center · USVA Center for Clinical Management Research · USWest Virginia University · US
Funding
Leveraging EHR data to evaluate key treatment decisions to prevent suicide-related behaviorsR01MH121478 · NIMH · HARVARD MEDICAL SCHOOL · PI KESSLER, RONALD C · 2020 to 2023
$3.1MImproving Depression Management in Primary CareIK2HX002867 · VA · VA GREATER LOS ANGELES HEALTHCARE SYSTEM · PI LEUNG, LUCINDA B · 2020 to 2025
–HSRD VA IK2 HX002867NIMH NIH HHS R01 MH121478
Abstract
introductionThe Veterans Health Administration (VHA) supports the nation's largest primary care-mental health integration (PC-MHI) collaborative care model to increase treatment of mild to moderate common mental disorders in primary care (PC) and refer more severe-complex cases to specialty mental health (SMH) settings. It is unclear how this treatment assignment works in practice.
methodsPatients (n = 2610) who sought incident episode VHA treatment for depression completed a baseline self-report questionnaire about depression severity-complexity. Administrative data were used to determine settings and types of treatment during the next 30 days.
resultsThirty-four percent (34.2%) of depressed patients received treatment in PC settings, 65.8% in SMH settings. PC patients had less severe and fewer comorbid depressive episodes. Patients with lowest severity and/or complexity were most likely to receive PC antidepressant medication treatment; those with highest severity and/or complexity were most likely to receive combined treatment in SMH settings. Assignment of patients across settings and types of treatment was stronger than found in previous civilian studies but less pronounced than expected (cross-validated AUC = 0.50-0.68). DISCUSSION: By expanding access to evidence-based treatments, VHA's PC-MHI increases consistency of treatment assignment. Reasons for assignment being less pronounced than expected and implications for treatment response will require continued study.
Indexed as
Delivery of Health Care, IntegratedMajor Depressive DisorderMental Health ServicesVeteransDepressionHumansUnited StatesUnited States Department of Veterans AffairsComorbidityDepressionIntegrated Health Care SystemsMental Health ServicesMilitary MedicinePrimary Health CarePsychotherapySelf-ReportVeterans Health
Identifiers
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.