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Health Care Assistants May Be Useful in Depression Care

Last Updated: September 15, 2009.

The use of case management in primary care settings, provided by health care assistants, may be helpful in improving care for patients with major depression, according to research published in the Sept. 15 issue of Annals of Internal Medicine.

TUESDAY, Sept. 15 (HealthDay News) -- The use of case management in primary care settings, provided by health care assistants, may be helpful in improving care for patients with major depression, according to research published in the Sept. 15 issue of Annals of Internal Medicine.

Jochen Gensichen, M.D., of the Friedrich Schiller University in Jena, Germany, and colleagues analyzed data from 626 adults with major depression from 74 primary care practices in Germany. Patients were assigned either to usual care or to case management provided by health care assistants, who mainly do administrative tasks and aren't necessarily college graduates. The intervention included regular telephone contact, symptom and medication monitoring, and support for medication adherence.

At 12 months, the researchers found that those in the intervention group had lower mean values in depression symptoms on the Patient Health Questionnaire-9, which was the primary outcome. Patients in the intervention group also gave a more favorable assessment of their quality of care and had better adherence to antidepressant medication.

"The current debate over health care reform in North America has generated much discussion of team-based care that goes beyond what transpires between the clinician and the patient in the context of an office visit. Massachusetts, in the next stage of its reform, is considering reimbursement for overall patient management rather than on a visit-by-visit basis. The patient-centered medical home is another manifestation. This study supports the wisdom of those directions," writes the author of an accompanying editorial.

The editorial author is a principal in a company that provides consulting to various health care organizations.

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