title: A Statewide Effort to Implement Collaborative Care for Depression: Reach and Impact for All Patients With Depression.
abstract: BACKGROUND
  Little is known about the reach and impact of collaborative care for depression outside of clinical trials.
  
  
  OBJECTIVE
  The objective of this study was to examine the effect of a collaborative care intervention for depression on the rates of depression diagnosis, use of specific depression codes, and treatment intensification.
  
  
  METHODS
  Evaluation of a staggered, multiple baseline implementation initiative.
  
  
  METHODS
  Patients receiving depression care in primary care clinics throughout Minnesota from February 2008 through March 2011.
  
  
  METHODS
  Data regarding depression diagnosis rates and codes, and measures of antidepressant intensification were provided by health insurers.
  
  
  RESULTS
  Depression Improvement Across Minnesota: Offering a New Direction (DIAMOND) affected neither rates of depression recognition nor use of depression diagnostic codes, and the overall reach of DIAMOND was disappointingly small. Patients in DIAMOND had more episodes of treatment intensification than non-DIAMOND patients, but we were unable to account for depression severity in our analysis.
  
  
  CONCLUSIONS
  DIAMOND did not affect depression recognition or diagnostic coding, but may have affected treatment intensification. Our results suggest that even strongly evidence-based interventions may have little contamination effects on patients not enrolled in the new care model.
authors.affiliation: *HealthPartners Institute †HealthPartners Behavioral Health, Minneapolis, MN ‡Division of Integrated Care and Public Health, University of Washington AIMS Center, Seattle, WA.
authors.forename: Rebecca C
authors.initials: RC
authors.lastname: Rossom
authors.forename: Leif I
authors.initials: LI
authors.lastname: Solberg
authors.forename: Emily D
authors.initials: ED
authors.lastname: Parker
authors.forename: A Lauren
authors.initials: AL
authors.lastname: Crain
authors.forename: Robin
authors.initials: R
authors.lastname: Whitebird
authors.forename: Michael
authors.initials: M
authors.lastname: Maciosek
authors.forename: Beth
authors.initials: B
authors.lastname: Molitor
authors.forename: Michael
authors.initials: M
authors.lastname: Trangle
authors.forename: Jürgen
authors.initials: J
authors.lastname: Unützer
mesh_terms: D003863:Depression / Q000175:diagnosis / Q000628:therapy*; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D008605:Mental Health Services / Q000458:organization & administration; D008910:Minnesota; D010348:Patient Care Team / Q000458:organization & administration; D015397:Program Evaluation; D016896:Treatment Outcome