The Research Question Clinical Effectiveness of Collaborative Care Management For Depression Over Time Garrison, GM; Angstman, KB; O’Connor S; Williams.

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Presentation transcript:

The Research Question Clinical Effectiveness of Collaborative Care Management For Depression Over Time Garrison, GM; Angstman, KB; O’Connor S; Williams MD; Lineberry TW How much more quickly do depressed patients treated with Collaborative Care Management (CCM) improve when compared to usual care (UC)? Why this is important? – We know CCM is superior to UC at 6 and 12 months – But, patients care about how quickly treatments improve symptoms – Survival analysis can tell us how quickly patients treated with CCM vs. UC improve

What the Researchers Did Retrospective Cohort of 7,340 patients diagnosed with major depression or dysthymia from 3/08-6/13 – Taken from primary care practice of over 100,000 – Bipolar disorder excluded – Enrollment in CCM was patient/primary MD decision Survival Analysis of subsequent PHQ-9 scores – Remission: PHQ9 < 5 – Persistent Depressive Sx: PHQ9 >= 10

What the Researchers Found Median Time-to-Remission (p<0.001) CCM: 86 d (95% CI: 81-91) UC: 614d (95% CI: ) Median Time-with-PDS (p<0.001) CCM: 31 d (95% CI: 30-33) UC: 154 d (95% CI: )

What This Means for Clinical Practice Patients care about how quickly they improve CCM shows improvement over UC within 1 st month Non-randomized study may be biased due to self-selection and sampling Survival Analysis may be superior to Logistic Regression at fixed endpoint for comparison of many chronic disease treatments