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Clinical effectiven...
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
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- af Winklerfelt Hammarberg, Sandra (författare)
- Karolinska Institutet
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- Björkelund, Cecilia, 1948 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa,Institute of Medicine, School of Public Health and Community Medicine
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- Nejati, Shabnam, 1972 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa,Institute of Medicine, School of Public Health and Community Medicine
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- Magnil, Maria, 1952 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa,Institute of Medicine, School of Public Health and Community Medicine
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- Hange, Dominique, 1963 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa,Institute of Medicine, School of Public Health and Community Medicine
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- Svenningsson, Irene, 1957 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa,Institute of Medicine, School of Public Health and Community Medicine
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- Petersson, Eva-Lisa (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa,Institute of Medicine, School of Public Health and Community Medicine
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- Andre, Malin (författare)
- Uppsala universitet,Allmänmedicin och preventivmedicin
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- Udo, Camilla (författare)
- Marie Cederschiöld högskola,Högskolan Dalarna,Uppsala universitet,Centrum för klinisk forskning Dalarna,Dalarna Univ, Sch Hlth & Welf, Falun, Sweden.;Marie Cederschiold Univ, Div Hlth Care Sci, Stockholm, Sweden.,Socialt arbete,Division of Health Care Science, Marie Cederschiöld University, Stockholm; Center for Clinical Research Dalarna, Uppsala University, Falun,Institutionen för vårdvetenskap,Högskolan Dalarna; Uppsala universitet
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- Ariai, Nashmil, 1963 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa,Institute of Medicine, School of Public Health and Community Medicine
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- Wallin, Lars (författare)
- Högskolan Dalarna,Omvårdnad,Dalarna Univ, Sch Hlth & Welf, Falun, Sweden.
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- Wikberg, Carl (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa,Institute of Medicine, School of Public Health and Community Medicine
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- Westman, Jeanette (författare)
- Karolinska Institutet
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(creator_code:org_t)
- 2022-08-09
- 2022
- Engelska.
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Ingår i: BMC Primary Care. - : Springer Nature. - 2731-4553. ; 23:1
- Relaterad länk:
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https://doi.org/10.1...
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https://uu.diva-port... (primary) (Raw object)
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https://du.diva-port... (primary) (Raw object)
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https://urn.kb.se/re...
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https://doi.org/10.1...
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https://urn.kb.se/re...
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https://urn.kb.se/re...
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http://kipublication...
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https://gup.ub.gu.se...
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Abstract
Ämnesord
Stäng
- Background In previous studies, we investigated the effects of a care manager intervention for patients with depression 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 was to compare the long-term effectiveness of care management and usual care for primary care patients with depression on depressive symptoms, remission, quality of life, self-efficacy, confidence in care, and quality of care 12 and 24 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 Vastra Gotaland and Dalarna, Sweden. Patients >= 18 years with newly diagnosed mild to moderate depression (n = 376: 192 intervention, 184 control) were included. Patients at intervention centers co-developed a structured depression care plan with a care manager. Via 6 to 8 telephone contacts over 12 weeks, the care manager followed up symptoms and treatment, encouraged behavioral activation, provided education, and communicated with the patient's general practitioner as needed. Patients at control centers received usual care. Adjusted mixed model repeated measure analysis was conducted on data gathered at 12 and 24 months on depressive symptoms and remission (MADRS-S); quality of life (EQ5D); and self-efficacy, confidence in care, and quality of care (study-specific questionnaire). Results The intervention group had less severe depressive symptoms than the control group at 12 (P = 0.02) but not 24 months (P = 0.83). They reported higher quality of life at 12 (P = 0.01) but not 24 months (P = 0.88). Differences in 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 the primary care center. Conclusions Patients with depression who had a care manager maintained their 6-month improvements in symptoms at the 12- and 24-month follow-ups. Without a care manager, recovery could take up to 24 months. Patients with care managers also had significantly more confidence in primary care and belief in future support than controls.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Omvårdnad (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Nursing (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Allmänmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- General Practice (hsv//eng)
Nyckelord
- Care manager
- Collaborative care
- Depression
- Primary health care
- Quality of life
- Symptom severity
- Confidence in care
- Care Manager - Vårdsamordnare som spindeln i nätet för patienter med depression i primärvården
- Depression
- therapy
- Follow-Up Studies
- Humans
- Primary Health Care
- Quality of Life
- Treatment Outcome
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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Till lärosätets databas
- Av författaren/redakt...
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af Winklerfelt H ...
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Björkelund, Ceci ...
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Nejati, Shabnam, ...
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Magnil, Maria, 1 ...
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Hange, Dominique ...
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Svenningsson, Ir ...
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visa fler...
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Petersson, Eva-L ...
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Andre, Malin
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Udo, Camilla
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Ariai, Nashmil, ...
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Wallin, Lars
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Wikberg, Carl
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Westman, Jeanett ...
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- Om ämnet
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Hälsovetenskap
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och Omvårdnad
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Allmänmedicin
- Artiklar i publikationen
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BMC Primary Care
- Av lärosätet
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Uppsala universitet
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Högskolan Dalarna
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Marie Cederschiöld högskola
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Karolinska Institutet
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Göteborgs universitet