title: Long-term effects of a collaborative care intervention on process of care in family practices in Germany: a 24-month follow-up study of a cluster randomized controlled trial.
abstract: OBJECTIVE
  The aims of this study were (1) to assess the long-term effects of a collaborative care intervention for patients with depression on process of care outcomes, and (2) to describe whether case management was continued after the end of the original one-year intervention.
  
  
  METHODS
  This 24-month follow-up of a randomized controlled trial took place 12 months after the end of the 1-year intervention. Data collection occurred by means of self-rating questionnaires and from medical records. We calculated linear mixed and logistic generalized estimating equation models.
  
  
  RESULTS
  Of the 626 patients included at baseline, 439 (70.1%) participated in this follow-up. Intervention recipients gave higher ratings than control recipients in terms of mean overall Patient Assessment of Chronic Illness Care (PACIC) scores (3.12 vs. 2.86; P = .019), but no difference was found in medication adherence (mean Morisky score 2.59 vs. 2.65, P = .56), prescribed antidepressant medications (60.2% vs. 55.1%; P = .25), visits to the family physician (15.96 vs. 14.46, P = .58) or mental health specialist (3.01 vs. 2.94, P = .94) over the 12 month follow-up period. Case management was continued for 47 (22.5%) selected intervention patients after the original intervention had ended.
  
  
  CONCLUSIONS
  At 24 months, intervention and control recipients had different PACIC ratings, but other process of care outcomes did not differ.
  
  
  CONCLUSIONS
  The main effects of the intervention are apparent at 12 months.
authors.affiliation: Institute of General Practice, Goethe-University Frankfurt am Main, Theodor-Stern-Kai 7, 60590 Frankfurt/Main, Germany. Electronic address: petersen@allgemeinmedizin.uni-frankfurt.de.
authors.forename: Juliana J
authors.initials: JJ
authors.lastname: Petersen
authors.affiliation: Institute of Medical Biostatistics, Epidemiology and Informatics, University Mainz, Obere Zahlbacher Str. 69, 55131 Mainz, Germany.
authors.forename: Jochem
authors.initials: J
authors.lastname: König
authors.affiliation: Institute of General Practice, Goethe-University Frankfurt am Main, Theodor-Stern-Kai 7, 60590 Frankfurt/Main, Germany.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Paulitsch
authors.affiliation: Institute of General Practice, Goethe-University Frankfurt am Main, Theodor-Stern-Kai 7, 60590 Frankfurt/Main, Germany.
authors.forename: Karola
authors.initials: K
authors.lastname: Mergenthal
authors.affiliation: Institute of General Practice, Goethe-University Frankfurt am Main, Theodor-Stern-Kai 7, 60590 Frankfurt/Main, Germany.
authors.forename: Sandra
authors.initials: S
authors.lastname: Rauck
authors.affiliation: Institute of General Practice, Goethe-University Frankfurt am Main, Theodor-Stern-Kai 7, 60590 Frankfurt/Main, Germany.
authors.forename: Manuel
authors.initials: M
authors.lastname: Pagitz
authors.affiliation: Institute of General Practice and Family Medicine, Jena University Hospital, Friedrich Schiller University, Bachstraße 18, 07743 Jena, Germany.
authors.forename: Konrad
authors.initials: K
authors.lastname: Schmidt
authors.affiliation: Institute of General Practice and Family Medicine, Jena University Hospital, Friedrich Schiller University, Bachstraße 18, 07743 Jena, Germany.
authors.forename: Lydia
authors.initials: L
authors.lastname: Haase
authors.affiliation: Institute of General Practice, Goethe-University Frankfurt am Main, Theodor-Stern-Kai 7, 60590 Frankfurt/Main, Germany.
authors.forename: Ferdinand M
authors.initials: FM
authors.lastname: Gerlach
authors.affiliation: Institute of General Practice, Goethe-University Frankfurt am Main, Theodor-Stern-Kai 7, 60590 Frankfurt/Main, Germany; Institute of General Practice and Family Medicine, Jena University Hospital, Friedrich Schiller University, Bachstraße 18, 07743 Jena, Germany.
authors.forename: Jochen
authors.initials: J
authors.lastname: Gensichen
mesh_terms: D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use*; D019090:Case Management; D003299:Cooperative Behavior; D003865:Major Depressive Disorder / Q000188:drug therapy*; D005194:Family Practice / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D055118:Medication Adherence; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011570:Psychiatry / Q000379:methods* / Q000706:statistics & numerical data
chemical_list: D000928:Antidepressive Agents
keywords: Case management; Healthcare assistants; Major depression; Primary healthcare