Ongoing Care Eases Depression, Saves Money

Taking a continuous-care approach to treating people with depression leads to improved outcomes and saves on costs, according to a new report.

In fact, Dr. Kathryn Rost from the University of Colorado Health Sciences Center, Aurora, told Reuters Health that “health plans interested in improving the treatment they provide for depression … need to adopt models that provide care management on an ongoing basis, rather than an acute basis.” “These models,” she said, “provide increasingly better patient outcomes at increasingly less cost over two years.” In particular, Rost and colleagues compared the cost-effectiveness of usual acute care with that of enhanced ongoing care in 211 adults beginning treatment for major depression in 12 primary care practices. Practices assigned to enhanced care supplemented their usual acute care approach by encouraging patients to engage in active psychotherapy and medication treatment pharmacotherapy, and by having practice nurses provide regularly scheduled care over 2 years. Those patients assigned to enhanced care had significantly more depression-free days over the 2 years than patients assigned to usual care (648 versus 588 days), the team reports in the Annals of Family Medicine. In addition, incremental health plan costs decreased significantly. These data, say the authors, provide “the first evidence that depression disease management can become more effective and less costly with time” and show that ongoing primary care-based depression management offers “good value.” (Source: Annals of Family Medicine: Reuters Health: February 2005.)