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Progress on Primary Care Management of Depression

Allen J. Dietrich, MD
[+] Article, Author, and Disclosure Information

From Dartmouth Medical School, Hanover, NH 03755.

Potential Financial Conflicts of Interest:Consultancies: Dr. Dietrich is 1 of 2 principals in 3CM, LLC, a consulting firm that provides consultation services to health care organizations in the United States, including the Department of Defense, the City of New York, the Veterans Administration, and various insurance plans. Grants received: MacArthur Initiative on Depression and Primary Care.

Requests for Single Reprints: Allen J. Dietrich, MD, Dartmouth Hitchcock Medical Center, 1 Medical Center Drive, Rubin 833, Lebanon, NH 03756.

Ann Intern Med. 2009;151(6):425-426. doi:10.7326/0003-4819-151-6-200909150-00008
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In this issue, a report from Germany provides important guidance for primary care clinicians and policymakers. Working with 74 small primary care practices in a cluster randomized trial, Gensichen and colleagues (1) found that provision of telephone support by practice staff to patients with depression improved 12-month depression outcomes. At baseline, 75% of patients were already in treatment (others were identified through screening) and symptoms were moderately severe, with Patient Health Questionnaire-9 (PHQ-9) scores of 17 (2). At 12 months, depression severity scores showed moderate but significantly greater improvement for the intervention group than for the control group (intervention recipients scored 1.41 points lower on the PHQ-9). Response, defined as a decrease of at least 50% in scores, was attained by 41% of patients in the intervention group versus 27% in the control group.

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