Implementation Support Substantially Improves Outcomes

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A new study published in Health Affairs collected data on depression outcomes from 135 primary care clinics with Collaborative Care programs. This study is the largest survey of Collaborative Care programs to date, and shows that clinics receiving ongoing implementation support, such as coaching from the AIMS Center, are almost twice as likely to achieve better depression outcomes. 

Abstract

Randomized controlled trials have demonstrated that the collaborative care model for depression primary care is more effective than usual care, but little is known about the effectiveness of this approach in real-world settings. We used patient-reported outcome data from 11,303 patients receiving collaborative care for depression in 135 primary care clinics to examine variations in depression outcomes. The average treatment response across this large sample of clinics was substantially lower than response rates reported in randomized controlled trials, and substantial outcome variation was observed. Patient factors such as initial depression severity, clinic factors such as the number of years of collaborative care practice, and the degree of implementation support received were associated with depression outcomes at follow-up. Findings suggest that the level of implementation support could be an important influence on the effectiveness of collaborative care model programs. 

Jürgen Unützer et al, Variation in the Effectiveness of Collaborative Care for Depression: Does it Matter Where you Get your Care?, Health Affairs (2020). DOI: 10.1377/hlthaff.2019.01714