The Resource Determining key features of effective depression interventions, investigators, Lisa V. Rubenstein ... [et al.] ; statistician, Marika Suttorp ; research assistant, Breanne Johnsen, (electronic book)

Determining key features of effective depression interventions, investigators, Lisa V. Rubenstein ... [et al.] ; statistician, Marika Suttorp ; research assistant, Breanne Johnsen, (electronic book)

Label
Determining key features of effective depression interventions
Title
Determining key features of effective depression interventions
Statement of responsibility
investigators, Lisa V. Rubenstein ... [et al.] ; statistician, Marika Suttorp ; research assistant, Breanne Johnsen
Contributor
Subject
Language
  • eng
  • eng
Summary
Our main research question was whether there are specific design features of collaborative care interventions that are consistently associated with greater impact on depression symptoms compared to a usual care control group. We also aimed to explore additional outcomes including patient satisfaction and functioning. In addition, we asked whether there were specific design features of randomized trial evaluations of collaborative care that were associated with consistently greater effects. Secondarily, we aimed to assess whether any patient characteristics, such as comorbidities, were associated with differential collaborative care effects, and the degree to which model effects persisted over time. We investigated these goals based on the following research questions. (1) Primary Research Question: What is the core set of intervention features that characterize collaborative care interventions, and which additional features are most linked to enhanced outcome effects? (2) Secondary Research Question: Are there specific evaluation features among randomized trials of collaborative care that are associated with effect size differences, independently of intervention features? (3) Secondary Research Question: To what extent is collaborative care more effective than usual care for decreasing depressive symptoms among patients with comorbid mental health conditions (PTSD, dementia, anxiety, dysthymia, substance abuse) or medical conditions? Methods: We used a set of articles identified and preliminarily reviewed as part of an earlier, nonquantitative literature review on depression care models (Williams, Gerrity et al. 2007) to carry out quantitative meta-regression analysis of collaborative care features. Studies were high quality randomized trials of depression collaborative care interventions compared to usual care that incorporated at least two features of the chronic illness care model. At least one of these features had to directly support patients in completing depression treatment. We did not review studies that only sought to change primary care clinician behavior (e.g., using reminders), without an additional patient-directed component, such as care management. We contacted authors extensively to identify, clarify, or verify study variables such as chronic illness care features or patient population characteristics. We began our analyses by assessing correlations between features. For study outcomes, we evaluated the effect size across studies for changes in depression symptoms, and relative risk across studies for changes in rates of resolution of depression. For these analyses we used study effect sizes comparing intervention to usual care arms as the unit of analysis. The effect size analyses treated short (six weeks to four months), medium (five to eight months), and long (nine to twelve months) outcomes separately. We also measured intervention impact (high, medium, low and little or none) for each study based on reviewer ratings of de-identified sets of study outcomes, including adherence, patient satisfaction, and functioning. We eliminated variables with inadequate distributions for meaningful quantitative analysis, using a rule of thumb of at least three studies per variable category. We carried out univariate and multivariate regression to determine relationships between intervention and evaluation features and effectiveness. Finally, we conducted cross-case qualitative analysis (Miles and Huberman 1994) of intervention and evaluation features, including comorbidities, against intervention impact.
Member of
Cataloging source
DNLM
http://bibfra.me/vocab/relation/checktag
bWsWsauV6K8
Government publication
federal national government publication
Illustrations
illustrations
Index
no index present
Literary form
non fiction
Nature of contents
  • dictionaries
  • surveys of literature
  • technical reports
http://library.link/vocab/relatedWorkOrContributorName
  • Rubenstein, Lisa V
  • Williams, John W.
  • Danz, Marjorie
  • Shekelle, Paul G
  • Suttorp, Marika
  • Johnsen, Breanne
  • United States
  • United States
  • Greater Los Angeles Veterans Affairs Healthcare System (U.S.)
  • Southern California Evidence-Based Practice Center/RAND.
Series statement
Evidence-based synthesis program
http://library.link/vocab/subjectName
  • Depressive Disorder
  • Depression
  • Outcome Assessment (Health Care)
  • Patient Care Management
  • Outcome Assessment (Health Care)
  • Randomized Controlled Trials as Topic
  • Patient Care Team
  • Anxiety Disorders
  • Dementia
  • Dysthymic Disorder
  • Patient Satisfaction
  • Stress Disorders, Post-Traumatic
  • Substance-Related Disorders
  • Humans
  • United States
Label
Determining key features of effective depression interventions, investigators, Lisa V. Rubenstein ... [et al.] ; statistician, Marika Suttorp ; research assistant, Breanne Johnsen, (electronic book)
Instantiates
Publication
Note
"Prepared for: Department of Veterans Affairs, Veterans Health Administration, Health Services Research & Development Service, Washington, DC 20420. Prepared by: Greater Los Angeles Veterans Affairs Healthcare System/Southern California/RAND Evidence-based Practice Center, Los Angeles, CA."
Bibliography note
Includes bibliographical references
Color
black and white
Control code
1542126
Dimensions
unknown
Form of item
online
Specific material designation
remote
Label
Determining key features of effective depression interventions, investigators, Lisa V. Rubenstein ... [et al.] ; statistician, Marika Suttorp ; research assistant, Breanne Johnsen, (electronic book)
Publication
Note
"Prepared for: Department of Veterans Affairs, Veterans Health Administration, Health Services Research & Development Service, Washington, DC 20420. Prepared by: Greater Los Angeles Veterans Affairs Healthcare System/Southern California/RAND Evidence-based Practice Center, Los Angeles, CA."
Bibliography note
Includes bibliographical references
Color
black and white
Control code
1542126
Dimensions
unknown
Form of item
online
Specific material designation
remote

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