Flexible and targeted follow up of patients with depressive symptoms need not stretch the resources of a doctor's surgery but could massively improve outcomes in primary care according to new research from University of Michigan Health System.
Traditionally, it may be many months before someone who is seen ever so briefly by a doctor will have further contact from a health professional, by which time the condition may well have worsened. It is not enough to simply signpost a patient to some self-help resources and leave them to get on with it. A simple phone call and the opportunity to self-monitor were among the measures shown to improve the likelihood of symptoms being in remission eighteen months later.
The study, lead by Professor Michael Klinkman, M.D., M.S at the University of Michigan Medical School, compared 728 referred patients who received the extra interventions against a control group of 78 who got the traditional mode of treatment. Nearly twice as many (49.2%) of the treated group were in remission after 18 months, as in the control group (27.3%).
Professor Kinkman points out that the study included patients with “chronic issues who have had multiple depressive episodes in the past,” who are notoriously difficult to treat, and still saw an improvement in outcomes that was persistent over time.
Once again it is really no surprise to learn that more engagement and involvement and a more human touch from healthcare practitioners results in improvements to the success of the care; but the take-home message of this study is that it does not take very much more effort and input to almost double the efficacy of that care. This is encouraging and should have implications for the treatment of other disorders, too.
The study is published under "Long-Term Clinical Outcomes of Care Management for Chronically Depressed Primary Care Patients: A Report From the Depression in Primary Care Project." in Annals of Family Medicine, September/October 2010.
Source: University of Michigan Health System