Case Management for Depression in Primary Care

Although systems and chronic-care strategies clearly are required to manage depressed patients well in primary care settings, implementation is challenging. In a cluster randomized trial, researchers in Germany assigned 74 small primary care practices either to provide depression case management — monitoring of symptoms and medication adherence, encouragement to follow self-management activities, and sharing of information between case managers and family physicians — or to provide usual care only. Healthcare assistants in the intervention practices received 17 hours of training in depression-care case management.

Participating practices enrolled 626 patients with major depression. At 12 months, case-management recipients had a significantly…