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In primary care settings, many patients suffer from both depression and chronic musculoskeletal pain, and treating both conditions is difficult. In a controlled trial that involved primary care settings in Indianapolis, investigators evaluated a treatment approach among 250 adults (mean age, 55) who had moderate-to-severe musculoskeletal pain (back, hip, or knee) of at least 3 months’ duration and at least moderate symptoms on standardized depression questionnaires.
The patients were randomized to a structured intervention or usual care. Intervention patients received intensive depression management with medication and supportive counseling, delivered by a physician-supervised nurse care manager, for 12 weeks; during the next 12 weeks, inter…