title: Act In case of Depression: the evaluation of a care program to improve the detection and treatment of depression in nursing homes. Study Protocol.
abstract: BACKGROUND
  The aim of this study is evaluating the (cost-) effectiveness of a multidisciplinary, evidence based care program to improve the management of depression in nursing home residents of somatic and dementia special care units. The care program is an evidence based standardization of the management of depression, including standardized use of measurement instruments and diagnostical methods, and protocolized psychosocial, psychological and pharmacological treatment.
  
  
  METHODS
  In a 19-month longitudinal controlled study using a stepped wedge design, 14 somatic and 14 dementia special care units will implement the care program. All residents who give informed consent on the participating units will be included. Primary outcomes are the frequency of depression on the units and quality of life of residents on the units. The effect of the care program will be estimated using multilevel regression analysis. Secondary outcomes include accuracy of depression-detection in usual care, prevalence of depression-diagnosis in the intervention group, and response to treatment of depressed residents. An economic evaluation from a health care perspective will also be carried out.
  
  
  CONCLUSIONS
  The care program is expected to be effective in reducing the frequency of depression and in increasing the quality of life of residents. The study will further provide insight in the cost-effectiveness of the care program.
  
  
  BACKGROUND
  Netherlands Trial Register (NTR): NTR1477.
authors: Department of Primary and Community Care, Center for Family Medicine, Geriatric Care and Public health, Radboud University Nijmegen Medical Centre, the Netherlands. d.gerritsen@elg.umcn.nl
authors: Debby L
authors: DL
authors: Gerritsen
authors: Martin
authors: M
authors: Smalbrugge
authors: Steven
authors: S
authors: Teerenstra
authors: Ruslan
authors: R
authors: Leontjevas
authors: Eddy M
authors: EM
authors: Adang
authors: Myrra J F J
authors: MJ
authors: Vernooij-Dassen
authors: Els
authors: E
authors: Derksen
authors: Raymond T C  M
authors: RT
authors: Koopmans
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