Response to depression treatment in the Aging Brain Care Medical Home model.
OBJECTIVE
To evaluate the effect of the Aging Brain Care (ABC) Medical Home program's depression module on patients' depression severity measurement over time.


METHODS
Retrospective chart review.


METHODS
Public hospital system.


METHODS
Patients enrolled in the ABC Medical Home program between October 1, 2012 and March 31, 2014.


METHODS
The response of 773 enrolled patients who had multiple patient health questionnaire-9 (PHQ-9) scores recorded in the ABC Medical Home program's depression care protocol was evaluated. Repeatedly measured PHQ-9 change scores were the dependent variables in the mixed effects models, and demographic and comorbid medical conditions were tested as potential independent variables while including random effects for time and intercept.


RESULTS
Among those patients with baseline PHQ-9 scores >10, there was a significant decrease in PHQ-9 scores over time (P<0.001); however, the effect differed by gender (P=0.015). On average, women's scores (4.5 point drop at 1 month) improved faster than men's scores (1 point drop at 1 month). Moreover, both men and women had a predicted drop of 7 points (>50% decline from baseline) on the PHQ-9 at 6 months.


CONCLUSIONS
These analyses demonstrate evidence for the sustained effectiveness of the ABC Medical Home program at inducing depression remission outcomes while employing clinical staff who required less formal training than earlier clinical trials.
Indiana University Center for Aging Research; Regenstrief Institute, Inc.; Department of Medicine, Indiana University School of Medicine, Indianapolis, IN; Department of Medicine, University of Vermont College of Medicine, Burlington, VT.
Michael A
MA
LaMantia
Indiana University Center for Health Innovation and Implementation Science; Indiana Clinical and Translational Sciences Institute.
Anthony J
AJ
Perkins
Regenstrief Institute, Inc.; Department of Biostatistics, Indiana University School of Medicine.
Sujuan
S
Gao
Department of Psychiatry, Indiana University School of Medicine; Indiana University Alzheimer's Disease Center.
Mary G
MG
Austrom
Eskenazi Health, Indianapolis, IN.
Cathy A
CA
Alder
Department of Ophthalmology, Feinberg School of Medicine, Northwestern University; Veterans Affairs Health Services Research and Development Service, Chicago, IL.
Dustin D
DD
French
Regenstrief Institute, Inc.; Department of Medicine, Indiana University School of Medicine, Indianapolis, IN; Indiana University Center for Health Services and Outcomes Research, Indianapolis, IN, USA.
Debra K
DK
Litzelman
Department of Medicine, Indiana University School of Medicine, Indianapolis, IN.
Ann H
AH
Cottingham
Indiana University Center for Aging Research; Regenstrief Institute, Inc.; Department of Medicine, Indiana University School of Medicine, Indianapolis, IN; Indiana University Center for Health Innovation and Implementation Science.
Malaz A
MA
Boustani
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D002985:Clinical Protocols; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D018802:Patient-Centered Care / Q000458:organization & administration* / Q000592:standards; D012189:Retrospective Studies; D012737:Sex Factors; D012959:Socioeconomic Factors
Medicare; care coordination; geriatrics