Magazine article Clinical Psychiatry News

Collaborative Care Boosts Patient Compliance, Physician Satisfaction. (Psychiatrists, Primary Care Physicians)

Magazine article Clinical Psychiatry News

Collaborative Care Boosts Patient Compliance, Physician Satisfaction. (Psychiatrists, Primary Care Physicians)

Article excerpt

TORONTO - Collaborative treatment of mental illness by psychiatrists and primary care physicians significantly improved patient adherence, increased physician satisfaction, and cut health care costs almost in half, Dr. Wayne J. Katon reported at the annual conference of the Anxiety Disorders Association of America.

In the first study, Dr. Katon and his colleagues at the University of Washington, Seattle, compared the effectiveness of standard care vs. collaborative care (integrating primary care and psychiatric care) in treating 217 patients with depression. The researchers asked 25 primary care physicians at one clinic to refer to a psychiatrist all new cases of major depression or possible major depression that they were about to start on antidepressant medication. Patients were then randomized to get either standard care or collaborative care.

Under collaborative care, patients received an educational videotape about depression and answered a questionnaire about their symptoms. Primary care physicians went through a half-day psychiatric training session and received case-by-case feedback from a psychiatrist. Case conferences were held when needed.

The study showed that collaborative care increased the frequency and intensity of visits. Visits were longer with more extended follow-up. This allowed more time for patient education and for closer monitoring of side effects and depressive symptoms, Dr. Katon said.

About half of the patients identified for this study were diagnosed with major depression, and the other half were diagnosed with minor depression. For patients with both major and minor depression, the intervention markedly improved adherence to adequate doses of antidepressants for more than 90 days. About 75% of patients in the intervention group with major depression achieved a 50% reduction in symptom severity at 4 months, compared with about 40% of patients in the standard care group. …

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