Telemedicine Surpasses On-Site Depression Treatment in Small Remote Clinics

Identifying the optimal primary-care approach to depression treatment is a priority as these clinics see most patients with clinical depression. Researchers examined telemedicine and on-site treatment in a pragmatic, randomized, comparative effectiveness study involving five rural primary-care centers, none of which employed on-site mental-health specialists.

Of 19,285 patients screened, 2863 (15%) scored as depressed on the Patient Health Questionnaire, and 364 eligible patients were randomized and followed for 18 months. Treatments were on-site collaborative care (primary-care physician plus nurse care manager) or on-site primary-care physician plus telemedicine (telephone contact with off-site nurse care managers and pharmacists; access t…