The Article in Brief

Care Management for Depression in Primary Care Practice: Findings From the RESPECT-Depression Trial

Paul A. Nutting, MD, MSPH , and colleagues

Background Care management has been shown to be effective in treating depression. Care management for depression includes assessing and monitoring the patient's condition; determining the patient's preferences, barriers, and progress in treatment; providing education and developing treatment and self-management plans; coordinating care among caregivers; and encouraging patients to follow recommended treatment. Primary care doctors have been hesitant to adopt this model, and researchers set out to examine the reasons why.

What This Study Found Primary care clinicians see value in care management for their depressed patients and believe it improves the quality of care. Through interviews with 42 primary care clinicians, researchers also found that primary care practices are slow to adopt care management for depression because of lack of financial compensation and the competing time demands of primary care practice.

Implications

• The major barriers to more widespread use of care management in depression are largely economic and less related to attitudes and preferences of primary care clinicians.This underscores the urgency of reimbursement policies that include coverage of depression care management.