Navigating the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study: practical outcomes and implications for depression treatment in primary care.
The Sequenced Treatment Alternatives to Relieve Depression (STAR( *)D) study addressed many clinically relevant issues on treatment of depressed outpatients. The study used an equipoise-stratified randomization scheme that enhanced the real-world expediency of treatment options studied. Because patients who had significant comorbid medical and psychiatric problems were included, and care was provided in the outpatient primary care setting as well as in outpatient psychiatric centers, findings are relevant to primary care physicians. The use of measurement-based treatment protocols promotes objectivity in a realm of often subjective clinical decision making. Although STAR( *)D was unable to provide specific treatment comparisons for patients at all study levels, it succeeded in defining the prevalence of treatment-resistant depression and is a model for further practical clinical outcomes studies.
Cain
Robert A
RA
Cleveland Clinic Lerner College of Medicine, 9500 Euclid Avenue, Cleveland, OH 44195, USA. cainr@ccf.org
D000928:Antidepressive Agents / Q000494:pharmacology / Q000627:therapeutic use*; D002985:Clinical Protocols; D003863:Depression / Q000188:drug therapy* / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D010821:Physicians, Family; D011320:Primary Health Care; D011581:Psychological Tests; D016896:Treatment Outcome
D000928:Antidepressive Agents