Early experience of a pilot intervention for patients with depression and chronic medical illness in an urban ACO

Henry Chung, Azalea Kim, Charles J. Neighbors, Johnine Cummings, Sally Ricketts, Megan A. O'Grady, Donald Douglas Raum

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Objective: The objective was to describe the design, implementation and preliminary results of a collaborative care pilot program using hybrid colocation and centralized care management for patients with depression and chronic medical illness in an urban accountable care organization. Methods: Patients with chronic illness (diabetes mellitus, coronary artery disease and/or congestive heart failure) and comorbid depressive symptoms (Patient Health Questionnaire [PHQ]9 score ≥ 10) were enrolled. The interventions included collaborative care for depression and chronic conditions; behavioral support, including short-term psychotherapy by licensed clinical social worker on-site or telephonically; off-site nurse care management and psychiatrist consultation through an electronic medical record. Results: Forty-four percent of patients (n=61) achieved a depression response. In a diabetes subgroup with depression and glycosylated hemoglobin level HbA1c > 8 (n=21), 33% had a depression response with a minimum 0.5% HbA1c reduction. Among a subgroup (n=25) with Framingham risk score > 15% and depression, mean PHQ9 depression scores and mean Framingham scores were reduced by 35% and 34%, respectively. Conclusions: Early experience of the pilot for multiple chronic illnesses and depression appears feasible and shows initial promise.

Original languageEnglish (US)
Pages (from-to)468-471
Number of pages4
JournalGeneral Hospital Psychiatry
Volume35
Issue number5
DOIs
StatePublished - Sep 2013

Fingerprint

Chronic Disease
Depression
Accountable Care Organizations
Patient Care Management
Brief Psychotherapy
Electronic Health Records
Glycosylated Hemoglobin A
Psychiatry
Coronary Artery Disease
Diabetes Mellitus
Referral and Consultation
Heart Failure
Nurses
Health

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Early experience of a pilot intervention for patients with depression and chronic medical illness in an urban ACO. / Chung, Henry; Kim, Azalea; Neighbors, Charles J.; Cummings, Johnine; Ricketts, Sally; O'Grady, Megan A.; Raum, Donald Douglas.

In: General Hospital Psychiatry, Vol. 35, No. 5, 09.2013, p. 468-471.

Research output: Contribution to journalArticle

Chung, Henry ; Kim, Azalea ; Neighbors, Charles J. ; Cummings, Johnine ; Ricketts, Sally ; O'Grady, Megan A. ; Raum, Donald Douglas. / Early experience of a pilot intervention for patients with depression and chronic medical illness in an urban ACO. In: General Hospital Psychiatry. 2013 ; Vol. 35, No. 5. pp. 468-471.
@article{47818de6995243159cd15170bfbc0c9f,
title = "Early experience of a pilot intervention for patients with depression and chronic medical illness in an urban ACO",
abstract = "Objective: The objective was to describe the design, implementation and preliminary results of a collaborative care pilot program using hybrid colocation and centralized care management for patients with depression and chronic medical illness in an urban accountable care organization. Methods: Patients with chronic illness (diabetes mellitus, coronary artery disease and/or congestive heart failure) and comorbid depressive symptoms (Patient Health Questionnaire [PHQ]9 score ≥ 10) were enrolled. The interventions included collaborative care for depression and chronic conditions; behavioral support, including short-term psychotherapy by licensed clinical social worker on-site or telephonically; off-site nurse care management and psychiatrist consultation through an electronic medical record. Results: Forty-four percent of patients (n=61) achieved a depression response. In a diabetes subgroup with depression and glycosylated hemoglobin level HbA1c > 8 (n=21), 33{\%} had a depression response with a minimum 0.5{\%} HbA1c reduction. Among a subgroup (n=25) with Framingham risk score > 15{\%} and depression, mean PHQ9 depression scores and mean Framingham scores were reduced by 35{\%} and 34{\%}, respectively. Conclusions: Early experience of the pilot for multiple chronic illnesses and depression appears feasible and shows initial promise.",
author = "Henry Chung and Azalea Kim and Neighbors, {Charles J.} and Johnine Cummings and Sally Ricketts and O'Grady, {Megan A.} and Raum, {Donald Douglas}",
year = "2013",
month = "9",
doi = "10.1016/j.genhosppsych.2013.04.014",
language = "English (US)",
volume = "35",
pages = "468--471",
journal = "General Hospital Psychiatry",
issn = "0163-8343",
publisher = "Elsevier Inc.",
number = "5",

}

TY - JOUR

T1 - Early experience of a pilot intervention for patients with depression and chronic medical illness in an urban ACO

AU - Chung, Henry

AU - Kim, Azalea

AU - Neighbors, Charles J.

AU - Cummings, Johnine

AU - Ricketts, Sally

AU - O'Grady, Megan A.

AU - Raum, Donald Douglas

PY - 2013/9

Y1 - 2013/9

N2 - Objective: The objective was to describe the design, implementation and preliminary results of a collaborative care pilot program using hybrid colocation and centralized care management for patients with depression and chronic medical illness in an urban accountable care organization. Methods: Patients with chronic illness (diabetes mellitus, coronary artery disease and/or congestive heart failure) and comorbid depressive symptoms (Patient Health Questionnaire [PHQ]9 score ≥ 10) were enrolled. The interventions included collaborative care for depression and chronic conditions; behavioral support, including short-term psychotherapy by licensed clinical social worker on-site or telephonically; off-site nurse care management and psychiatrist consultation through an electronic medical record. Results: Forty-four percent of patients (n=61) achieved a depression response. In a diabetes subgroup with depression and glycosylated hemoglobin level HbA1c > 8 (n=21), 33% had a depression response with a minimum 0.5% HbA1c reduction. Among a subgroup (n=25) with Framingham risk score > 15% and depression, mean PHQ9 depression scores and mean Framingham scores were reduced by 35% and 34%, respectively. Conclusions: Early experience of the pilot for multiple chronic illnesses and depression appears feasible and shows initial promise.

AB - Objective: The objective was to describe the design, implementation and preliminary results of a collaborative care pilot program using hybrid colocation and centralized care management for patients with depression and chronic medical illness in an urban accountable care organization. Methods: Patients with chronic illness (diabetes mellitus, coronary artery disease and/or congestive heart failure) and comorbid depressive symptoms (Patient Health Questionnaire [PHQ]9 score ≥ 10) were enrolled. The interventions included collaborative care for depression and chronic conditions; behavioral support, including short-term psychotherapy by licensed clinical social worker on-site or telephonically; off-site nurse care management and psychiatrist consultation through an electronic medical record. Results: Forty-four percent of patients (n=61) achieved a depression response. In a diabetes subgroup with depression and glycosylated hemoglobin level HbA1c > 8 (n=21), 33% had a depression response with a minimum 0.5% HbA1c reduction. Among a subgroup (n=25) with Framingham risk score > 15% and depression, mean PHQ9 depression scores and mean Framingham scores were reduced by 35% and 34%, respectively. Conclusions: Early experience of the pilot for multiple chronic illnesses and depression appears feasible and shows initial promise.

UR - http://www.scopus.com/inward/record.url?scp=84884154462&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84884154462&partnerID=8YFLogxK

U2 - 10.1016/j.genhosppsych.2013.04.014

DO - 10.1016/j.genhosppsych.2013.04.014

M3 - Article

VL - 35

SP - 468

EP - 471

JO - General Hospital Psychiatry

JF - General Hospital Psychiatry

SN - 0163-8343

IS - 5

ER -