title: Treatment effects from UPBEAT: a randomized trial of care management for behavioral health problems in hospitalized elderly patients.
abstract: The purpose of this study was to examine the impact of the Unified Psychogeriatric Biopsychosocial Evaluation and Treatment (UPBEAT) Program, an interdisciplinary mental health care management program, on the behavioral health symptoms of elderly veterans. Participants, 60 years and older, included 2637 veterans recruited from medical/surgical units who screened positively for significant depressive or anxiety symptoms and/or at-risk alcohol drinking. Participants were randomized to UPBEAT or to usual care. Primary outcomes were measured at baseline and at 6, 12, and 24 months. Participant nonadherence to the protocol was common and is a major limitation. There were no differences between UPBEAT and usual care patients on symptom or functional outcomes at any follow-up point. Exploratory analyses suggested that among participants with more physical health problems, there were greater improvements in depressive symptoms in those assigned to UPBEAT care. Despite a theoretical and practically sound intervention, participation was low and treatment outcomes, while generally good, appeared unaffected by the addition of the program.
authors.affiliation: Section of Geriatric Psychiatry, Department of Psychiatry, University of Pennsylvania, 3535 Market Street, Room 3002, Philadelphia, PA 19104, USA. oslin@mail.med.upenn.edu
authors.forename: David W
authors.initials: DW
authors.lastname: Oslin
authors.forename: Richard
authors.initials: R
authors.lastname: Thompson
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Kallan
authors.forename: Thomas
authors.initials: T
authors.lastname: TenHave
authors.forename: Frederic C
authors.initials: FC
authors.lastname: Blow
authors.forename: Roshan
authors.initials: R
authors.lastname: Bastani
authors.forename: Robert L
authors.initials: RL
authors.lastname: Gould
authors.forename: Annette E
authors.initials: AE
authors.lastname: Maxwell
authors.forename: Joel
authors.initials: J
authors.lastname: Rosansky
authors.forename: William
authors.initials: W
authors.lastname: Van Stone
authors.forename: Lissy
authors.initials: L
authors.lastname: Jarvik
mesh_terms: D000368:Aged; D000437:Alcoholism / Q000150:complications / Q000523:psychology / Q000628:therapy*; D001008:Anxiety Disorders / Q000150:complications / Q000523:psychology / Q000628:therapy*; D001524:Behavioral Medicine / Q000379:methods*; D003866:Depressive Disorder / Q000150:complications / Q000523:psychology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D005852:Geriatric Psychiatry / Q000379:methods*; D006787:Hospitals, Veterans; D006801:Humans; D008297:Male; D008605:Mental Health Services; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life / Q000523:psychology; D016896:Treatment Outcome; D014481:United States; D014728:Veterans / Q000523:psychology*