Telephone program improves anti-depression treatments.

SEATTLE -- For primary care patients beginning antidepressant treatment, a telephone program integrating care management and structured cognitive-behavioral psychotherapy can significantly improve satisfaction and clinical outcomes according to a study conducted at the Center for Health Studies, Group Health Cooperative. These findings suggest a new public health model of psychotherapy for depression including active outreach and vigorous efforts to improve access to and motivation for treatment.

Patients were grouped in three programs: usual care, usual care plus telephone care management and telephone care management plus telephone psychotherapy. A total of 600 patients beginning antidepressant treatment for depression were systematically sampled from 7 group-model primary care clinics; patients already receiving psychotherapy were excluded. Patients were assessed at three months and six months.

Treatment participation rates were 97% for telephone care management and 93% for telephone care management plus psychotherapy. Compared with usual care, the telephone psychotherapy intervention led to lower mean Hopkins Symptom Checklist Depression Scale scores, a higher proportion of patients reporting that depression was "much improved", and a higher proportion of patients "very satisfied" with depression treatment. The study was reported in the Journal of the American Medical Association in August.