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Journal of General Internal Medicine

Erschienen in:

01.10.2007 | Original Article

Effect of Care Setting on Evidence-based Depression Treatment for Veterans with COPD and Comorbid Depression

verfasst von: Neil Jordan, PhD, Todd A. Lee, PharmD, PhD, Marcia Valenstein, MD, MS, Kevin B. Weiss, MD, MPH

Erschienen in: Journal of General Internal Medicine | Ausgabe 10/2007

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Abstract

Background

Patients with chronic obstructive pulmonary disorder (COPD) frequently have co-occurring depressive disorders and are often seen in multiple-care settings. Existing research does not assess the impact of care setting on delivery of evidence-based depression care for these patients.

Objective

To examine the prevalence of guideline-concordant depression treatment among these co-morbid patients, and to examine whether the likelihood of receiving guideline-concordant treatment differed by care setting.

Design

Retrospective cohort study.

Patients

A total of 5,517 veterans with COPD that experienced a new treatment episode for major depressive disorder.

Measurements and Main Results

Concordance with VA treatment guidelines for depression; multivariate analyses of the relationship between guideline-concordant depression treatment and care setting. More than two-thirds of the sample was over age 65 and 97% were male. Only 50.6% of patients had guideline-concordant antidepressant coverage (defined by the VA). Fewer than 17% of patients received guideline recommended follow-up (≥3 outpatient visits during the acute phase), and only 9.9% of the cohort received both guideline-concordant antidepressant coverage and follow-up visits. Being seen in a mental health clinic during the acute phase was associated with a 7-fold increase in the odds of receiving guideline-concordant care compared to primary care only. Patients seen in pulmonary care settings were also more likely to receive guideline-concordant care compared to primary care only.

Conclusions

Most VA patients with COPD and an acute depressive episode receive suboptimal depression management. Improvements in depression treatment may be particularly important for those patients seen exclusively in primary care settings.

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Titel: Effect of Care Setting on Evidence-based Depression Treatment for Veterans with COPD and Comorbid Depression
verfasst von: Neil Jordan, PhD
Todd A. Lee, PharmD, PhD
Marcia Valenstein, MD, MS
Kevin B. Weiss, MD, MPH
Publikationsdatum: 01.10.2007
Verlag: Springer-Verlag
Erschienen in: Journal of General Internal Medicine / Ausgabe 10/2007
Print ISSN: 0884-8734
Elektronische ISSN: 1525-1497
DOI: https://doi.org/10.1007/s11606-007-0328-8

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Abstract

Background

Objective

Design

Patients

Measurements and Main Results

Conclusions

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