scholarly journals Ways Community-Based Organizations Enhance Late-Life Depression Care in Partnership With Clinics

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 442-443
Author(s):  
Theresa Hoeft ◽  
Melissa Gosdin ◽  
Jenny Wagner ◽  
Stuart Henderson ◽  
Mindy Vredevoogd ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Late Life ◽  
Social Needs ◽  
Health Concern ◽  
Depression Care ◽  
Late Life Depression ◽  
Community Based ◽  
Primary Care Clinics ◽  
Community Based Organizations

Abstract Late-life depression is a serious public health concern in the U.S., especially as the population ages. To improve care coordination and increase the number of providers working to improve depression outcomes, primary care clinics and community-based organizations (CBOs) can partner and improve care. Addressing social determinants of health is one area CBOs can help respond to but there are other ways CBOs can bring value to these partnerships with primary care clinics. As part of a qualitative evaluation of the Care Partners Project, 84 key informant interviews and 20 focus groups were conducted over five years with selected primary care physicians, care managers, administrators and psychiatric consultants. These data were coded and organized using an inductive and deductive thematic analysis approach. CBOs contributed to care through 1) adding new services that focus on clients’ social needs (e.g., assistance locating affordable housing, reliable transportation, applying for social security benefits) that were foundational to effective depression care; 2) strengthening core aspects of existing care; 3) incorporating a lay health workforce to enhance care; and/or 4) adding home visits that supported deeper understanding of patient’s life context, enhanced trust and improved access to care. CBOs can enhance depression care through increasing access and quality of care. Findings can inform conversations about the value CBOs offer when partnering with health care systems and improve partnership efforts. Such conversations are worth revisiting as organizations deepen their connections and work together over time.

scholarly journals STRENGTHENING LATE-LIFE DEPRESSION COLLABORATIVE CARE THROUGH COMMUNITY ENGAGEMENT: CARE PARTNERS INITIATIVE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S572-S573
Author(s):  
Ladson Hinton ◽  
Theresa J Hoeft ◽  
Stuart Henderson ◽  
Melissa M Gosdin ◽  
Laura Rath ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Collaborative Care ◽  
Late Life ◽  
Lessons Learned ◽  
Successful Implementation ◽  
Depression Care ◽  
Late Life Depression ◽  
Primary Care Clinics ◽  
Care Partners

Abstract Despite the availability of effective treatments for late life depression, many older adults with depression either do not access or fully engage in treatment. The goal of this study was to examine the feasibility and two-year outcomes from an Archstone Foundation funded Care Partners Initiative to strengthen depression care for adults 65 years of age and older. Seven sites throughout California implemented evidence-based collaborative care through partnerships between primary care organizations, community-based organizations (CBOs), and families of older adults with depression. Evaluation used a mixed-methods approach incorporating both qualitative and quantitative data. Of the seven sites, six formed partnerships between primary care clinics and CBOs and one site only focused on engaging family members in treatment. In the first two years, 274 patients were enrolled and rates of depression improvement were comparable to prior depression care effectiveness trials. Overall, 49% of patients at CBO sites interacted 3+ times with CBO staff/clinicians, while at the family site, 79% of patients had 3+ contacts including a family member. Using data from key informant interviews, focus groups, and site progress documents, seven core components were identified that facilitated successful implementation and delivery of partnered collaborative care, including three foundational components: strong stakeholder buy-in, effective patient engagement, and the promotion of depression treatment as a core value across organizations. Multiple complexities of partnering between primary care clinics and CBOs or families were identified. Challenges and lessons learned from this initiative will also be discussed.

scholarly journals Complexity in partnerships: A qualitative examination of collaborative depression care in primary care clinics and community‐based organisations in California, United States

2020 ◽  
Vol 28 (4) ◽  
pp. 1199-1208
Author(s):  
Stuart Henderson ◽  
Jenny L. Wagner ◽  
Melissa M. Gosdin ◽  
Theresa J. Hoeft ◽  
Jürgen Unützer ◽  
...  
Keyword(s):  
United States ◽  
Primary Care ◽  
Depression Care ◽  
Community Based ◽  
Primary Care Clinics

The Prevalence of Late-Lifedepression and Physicians’ Attitude Toward it in Primary Care Settings of China

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
S. Chen
Keyword(s):  
Primary Care ◽  
Clinical Practice ◽  
Older People ◽  
Primary Care Physicians ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Late Life ◽  
Well Being ◽  
Late Life Depression ◽  
Primary Care Settings

Late-life depression is associated with physical and psychological comorbidity, functional and cognitive impairment, and increased mortality due to suicide and other causes. However, studies in the west show that the identification of depression in older people is problematic and consequently the illness is underdiagnosed and undertreated. We investigated the prevalence of late-life depression and physicians’ attitude toward it in primary care settings of China.The survey was performed in urban primary care settings of Hangzhou, China. 1000 patients aged ≥ 55 years and 300 primary care physicians were recruited, of which 689 patients and 247 physicians provided complete data. The Geriatric Depression Scale (GDS-30) was used for investigating the prevalence of late-life depression in patients, and the Depression Attitude Questionnaire (DAQ) for investigating physicians’ attitudes and knowledge about depression.Of the 689 patients, 23.4% (n=161) scored ≥ 11 on the GDS-30, including 3% (n=21) who scored ≥ 21. Among the physicians, 72% (n=178) endorsed that “Becoming depressed is a natural part of being old”, and 70% (n=173) of them thought “Working with depressed patients is heavy going”; in their clinical practice. Only 6.6% of physicians prescribed anti-depressants.Primary care physicians in China are ill prepared to diagnose and treat depression in older adults, which presents at high rates in primary care clinics. How to improve their attitudes and clinical practice is crucial to the well-being of older people in China.

Primary care physicians’ medical decision making for late-life depression

1996 ◽  
Vol 11 (4) ◽  
pp. 218-225 ◽  
Author(s):  
Christopher M. Callahan ◽  
Robert S. Dittus ◽  
William M. Tierney
Keyword(s):  
Primary Care ◽  
Decision Making ◽  
Primary Care Physicians ◽  
Medical Decision Making ◽  
Late Life ◽  
Medical Decision ◽  
Late Life Depression

Primary Care Physicians' Attitude Toward Diagnosis and Treatment of Late-life Depression

CNS Spectrums ◽  
2002 ◽  
Vol 7 (11) ◽  
pp. 784-790 ◽  
Author(s):  
Jeffrey S. Harman ◽  
Ellen L. Brown ◽  
Thomas Ten Have ◽  
Benoit H. Mulsant ◽  
Greg Brown ◽  
...  
Keyword(s):  
Primary Care ◽  
Medical Education ◽  
Primary Care Physicians ◽  
Late Life ◽  
The Elderly ◽  
Late Life Depression ◽  
Primary Care Settings ◽  
Care Groups ◽  
Physician Characteristics ◽  
Barrier To Care

ABSTRACTUnderdiagnosis and undertreatment of late-life depression is common, especially in primary care settings. To help assess whether physicians' attitude and confidence in diagnosing and managing depression serve as barriers to care, a total of 176 physicians employed in 18 primary care groups were administered surveys to assess attitudes towards diagnosis, treatment, and management of depression in elderly patients, (individuals over 65 years of age). Logistic regression was performed to assess the association of physician characteristics on attitudes. Nearly all of the physicians surveyed felt that depression in the elderly was a primary care problem, and 41% reported late-life depression as the most common problem seen in older patients. Physicians were confident in their ability to diagnose and manage depression, yet 45% had no medical education on depression in the previous three years. Physicians' confidence in their ability to diagnose, treat, and manage depression, and their reported adequacy of training, do not appear to correspond to the amount of continuing medical education in depression, suggesting that physician overconfidence may potentially be serving as a barrier to care.

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