The System of Care and Outcomes in Geriatric Depression

Comprehensive care management programs address both medication and psychosocial issues so that patients feel better attended to and fewer health problems fall between the cracks. In the Prevention of Suicide in Primary Care Elderly: Collaborative Trial (PROSPECT), 20 primary care practices were randomized to provide 2 years of either a care-manager algorithm-based treatment for depression or a slightly enhanced version of usual care (JW Psychiatry Apr 22 2004). Study participants were 599 depressed patients aged 60 or older (67% with diagnoses of major depression; 72% women). The care managers helped physicians recognize depression, provided algorithm-based treatment recommendations, monitored symptoms and medication adverse effects, addres…