RESEARCH DESIGN AND METHODS We screened diabetes patients for depression, and for those with depressive symptoms, we provided depression care management.
The L/40 guns were mounted in Drh.L. C/92 type turrets, which provided depression to −5 degrees and elevation to 25 degrees.
In total, 457 clients provided anxiety scores and 458 clients provided depression scores at both pre- and post-assessment.
Nurse-led DCM typically involves a trained nurse care manager who works in collaboration with primary care providers, specialized mental healthcare providers, and other members of the IP team, to provide depression screening, outreach, and treatments [ 88, 89].
Three systematic reviews [ 26- 28] on the evidence for screening for depression in primary care settings concluded that reporting screening results to primary care practitioners can improve depressive symptoms when there is additional staff providing depression care support.
The 2009 recommendations are more restrictive and specify that the screening should not be applied unless there is support from additional staff to provide depression care [ 8].
The cost of providing depression care management in this setting is modest and consistent with earlier cost estimates for the IMPACT program (7).
Table 1 shows the number of entrants to the Core Science and Clinical components for each year of entry (2007 2010) and those participating each year and providing depression data.
A recent trial of collaborative care, an enhanced depression care intervention which provides depression severity related treatment guidance, found improvement in both depression and control of medical disease at 1 year post intervention in patients with heart disease and/or diabetes [ 7].
We randomized depressed adult Medicaid patients in 2 primary care practices in Western North Carolina to a GCM intervention or to UC. GCMs, already providing services in diabetes and asthma in both study arms, were further trained to provide depression services including self-management, decision support, use of information systems, and care management.
Licensed senior center social workers trained in BTB meet with participants at home for up to 10 sessions over 4 months to assess care needs, make referrals/linkages, provide depression education, instruct in stress reduction techniques, and use behavioral activation to identify goals and steps to achieve them.
