Dalarna University's logo and link to the university's website

du.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • chicago-author-date
  • chicago-note-bibliography
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Clinical effectiveness of care managers in collaborative primary health care for patients with depression: 12‑ and 24‑month follow‑up of a pragmatic cluster randomized controlled trial
Karolinska Institutet, Stockholm, Academic Primary Health Care Centre, Region Stockholm, Stockholm.
Sahlgrenska Academy, University of Gothenburg, Gothenburg.
Sahlgrenska Academy, University of Gothenburg, Gothenburg.
Sahlgrenska Academy, University of Gothenburg, Gothenburg.
Show others and affiliations
Number of Authors: 132022 (English)In: BMC Primary Care, E-ISSN 2731-4553, Vol. 23, no 1, article id 198Article in journal (Refereed) Published
Abstract [en]

Background: In previous studies, we investigated the effects of a care manager intervention for patients withdepression treated in primary health care. At 6 months, care management improved depressive symptoms, remission,return to work, and adherence to anti-depressive medication more than care as usual. The aim of this study wasto compare the long-term effectiveness of care management and usual care for primary care patients with depressionon depressive symptoms, remission, quality of life, self-efficacy, confidence in care, and quality of care 12 and24 months after the start of the intervention.Methods: Cluster randomized controlled trial that included 23 primary care centers (11 intervention, 12 control)in the regions of Västra Götaland and Dalarna, Sweden. Patients ≥18 years with newly diagnosed mild to moderatedepression (n = 376: 192 intervention, 184 control) were included. Patients at intervention centers co-developed astructured depression care plan with a care manager. Via 6 to 8 telephone contacts over 12 weeks, the care managerfollowed up symptoms and treatment, encouraged behavioral activation, provided education, and communicatedwith the patient’s general practitioner as needed. Patients at control centers received usual care. Adjusted mixedmodel repeated measure analysis was conducted on data gathered at 12 and 24 months on depressive symptomsand remission (MADRS-S); quality of life (EQ5D); and self-efficacy, confidence in care, and quality of care (study-specificquestionnaire).Results: The intervention group had less severe depressive symptoms than the control group at 12 (P = 0.02) butnot 24 months (P = 0.83). They reported higher quality of life at 12 (P = 0.01) but not 24 months (P = 0.88). Differencesin remission and self-efficacy were not significant, but patients in the intervention group were more confident that they could get information (53% vs 38%; P = 0.02) and professional emotional support (51% vs 40%; P = 0.05) from theprimary care center.Conclusions: Patients with depression who had a care manager maintained their 6-month improvements in symptomsat the 12- and 24-month follow-ups. Without a care manager, recovery could take up to 24 months. Patients withcare managers also had significantly more confidence in primary care and belief in future support than controls.

Place, publisher, year, edition, pages
2022. Vol. 23, no 1, article id 198
Keywords [en]
Care manager, Collaborative care, Depression, Primary health care, Quality of life, Symptom severity, Confidence in care
National Category
General Practice
Research subject
Health and Welfare, Care Manager - Vårdsamordnare som spindeln i nätet för patienter med depression i primärvården
Identifiers
URN: urn:nbn:se:du-42126DOI: 10.1186/s12875-022-01803-xISI: 000838085200003PubMedID: 35945493Scopus ID: 2-s2.0-85135687418OAI: oai:DiVA.org:du-42126DiVA, id: diva2:1687347
Funder
Region Västra GötalandKarolinska InstituteAvailable from: 2022-08-15 Created: 2022-08-15 Last updated: 2024-04-05

Open Access in DiVA

fulltext(1268 kB)152 downloads
File information
File name FULLTEXT01.pdfFile size 1268 kBChecksum SHA-512
7adc87fc25ba9e6accd7431f2648f486b616cc701d6f5859ad490d6a25f7e44ac178b017ebaef9d28a99359dd75867d475d79917280dcedd53216eced8030793
Type fulltextMimetype application/pdf

Other links

Publisher's full textPubMedScopus

Authority records

Udo, CamillaWallin, Lars

Search in DiVA

By author/editor
Udo, CamillaWallin, Lars
By organisation
Social WorkCaring Science/Nursing
In the same journal
BMC Primary Care
General Practice

Search outside of DiVA

GoogleGoogle Scholar
Total: 153 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 439 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • chicago-author-date
  • chicago-note-bibliography
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf