Treating depressed older adults in primary care: narrowing the gap between efficacy and effectiveness.
There is a gap between the efficacy of treatments for late-life depression under research conditions and the effectiveness of treatments as they occur in the "real world" of primary care. Considerable evidence supports the efficacy of treatments for late-life depression, but many depressed older adults either are not recognized or do not receive effective treatment for depression in primary care. Older adults face a range of special treatment barriers: knowledge deficits; losses and social isolation; multiple medical problems; and lack of financial resources. More research is needed to understand these barriers and to study the effectiveness of multifaceted, population-based disease management interventions for late-life depression in primary care.
Unützer
J
J
Center for Health Services Research, UCLA Neuropsychiatric Institute 90024, USA. unutzer@ucla.edu
Katon
W
W
Sullivan
M
M
Miranda
J
J
D000368:Aged; D003695:Delivery of Health Care; D003863:Depression / Q000453:epidemiology / Q000628:therapy*; D003866:Depressive Disorder / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D006297:Health Services Accessibility; D006299:Health Services for the Aged; D006801:Humans; D008297:Male; D011320:Primary Health Care; D016896:Treatment Outcome; D014481:United States