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 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 The prognosis of depression in late life versus mid-life: implications for the treatment of older adults

2005 ◽  
Vol 17 (4) ◽  
pp. 533-538 ◽  
Author(s):  
Hari Subramaniam ◽  
Alex J. Mitchell
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Nursing Homes ◽  
Late Life ◽  
Clinical Excellence ◽  
Late Life Depression ◽  
Medical Settings ◽  
Nice Guidelines ◽  
Primary Care Settings

Depression in late life is extremely common. Of those aged 65 years or older, 2–5% have syndromal depression, but up to 20% of elderly people have depressive symptoms (Horwath et al., 2002). Both syndromal and subsyndromal depression carry a high risk of long-term complications and both are associated with elevated risks of morbidity and mortality (Penninx et al., 1999). Despite repeated alerts, depression is consistently under-recognized in acute medical settings, in nursing homes and in primary care (Volkers et al., 2004). For reasons that are inadequately understood, late-life depression seems to be under-treated to an even greater extent than depression in mid-life (Mackenzie et al., 1999). This issue is particularly important, given that effective and safe treatments for depression are available (Bartels et al., 2003), even though the evidence regarding maintenance therapies in older people is inconsistent (Geddes et al., 2003; Wilson et al., 2003). Recent evidence suggests that a package of care can improve the care of older depressed patients in primary care settings (Bruce et al., 2004) and in nursing homes (Ciechanowski et al., 2004). This has led to the development of several clinical guidelines specifically for late-life depression (Baldwin et al., 2003; Charney et al., 2003; Lebowitzet al., 1997). Yet, in the recent National Institute of Clinical Excellence (NICE) guidelines for the management of depression in primary and secondary care, no distinction was made between early, middle and late-life depression (Malone and Mitchell, 2005).

Collaborative care for primary care treatment of late‐life depression in Singapore: Randomized controlled trial

2020 ◽  
Vol 35 (10) ◽  
pp. 1171-1180
Author(s):  
Tze Pin Ng ◽  
Ma S. Z. Nyunt ◽  
Liang Feng ◽  
Rajeev Kumar ◽  
Calvin S. L. Fones ◽  
...  
Keyword(s):  
Primary Care ◽  
Randomized Controlled Trial ◽  
Collaborative Care ◽  
Controlled Trial ◽  
Late Life ◽  
Late Life Depression ◽  
Randomized Controlled ◽  
Care Treatment

The Recognition and Treatment of Late-Life Depression: A View from Primary Care

1996 ◽  
Vol 26 (2) ◽  
pp. 155-171 ◽  
Author(s):  
Christopher M. Callahan ◽  
Hugh C. Hendrie ◽  
William M. Tierney
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Depressive Symptoms ◽  
Primary Care Physicians ◽  
Late Life ◽  
Primary Care Providers ◽  
Future Research ◽  
Care Providers ◽  
Late Life Depression ◽  
Primary Care Patients

Objective: Efforts to improve the recognition and treatment of late-life depression in primary care are often based on the assumption that primary care physicians underutilize currently available and effective treatments. This article reviews the validity of this assumption and offers recommendations for future research. Methods: Clinical trials designed to improve the recognition and treatment of late-life depression in primary care are reviewed. Because studies limited to older adults are rare, we also include studies enrolling younger patients. These data are reviewed in the context of recent reviews on the prevalence of depression in primary care settings and the effectiveness of available treatments. Results: Although depressive symptoms are common among older adults, there is insufficient literature documenting the proportion of these patients who respond to currently available treatments. Patients with uncomplicated major depressive disorder constitute the minority of primary care patients with depressive symptoms. Nearly all available studies of treatment effectiveness of pharmacotherapy or psychotherapy focus on older adults with uncomplicated major depression. Currently available treatment options may apply to less than 15 percent of depressed primary care patients. Conclusions: More research is needed to help primary care providers manage their depressed patients with comorbid medical conditions, functional disability, or minor or chronic depressions. In addition, more research is needed to identify those patients who would benefit from specialized or interdisciplinary care.

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