Author information
1
Department of Gastroenterology and Hepatology, Baylor College of Medicine, Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX.
2
Psychiatric Research Institute, University of Arkansas for Medical Sciences, North Little Rock, AR.
3
Center for Mental Health Outcomes Research, Central Arkansas Veterans Healthcare System, North Little Rock, AR.
4
Hepatitis C Clinic, Infectious Diseases, Baylor College of Medicine, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX.
5
John Cochran VA Medical Center, Gastroenterology Section (111/JC/GI), St. Louis, MO.
6
Washington University School of Medicine, John Cochran Veterans Affairs Medical Center, Gastroenterology Section (111/JC/GI), St. Louis, MO.
7
Central Arkansas Veterans Healthcare System, Little Rock, AR.
8
Infectious Diseases, VA Greater Los Angeles Healthcare System, Los Angeles, CA.
9
Department of Medicine, Baylor College of Medicine, Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX.
10
Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX.
11
Division of Health Services Research, Department of Medicine, Baylor College of Medicine, Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Veterans Affairs South Central Mental Illness Research Education and Clinical Center (MIRECC), Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX.
12
Section of Gastroenterology, Baylor College of Medicine, Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX.
13
Departments of Health Policy and Management and Medicine, Boston University, Boston, MA.
14
Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, Edith Nourse Rogers Memorial VA Hospital, Boston, MA.
15
Center for Innovation to Implementation - Ci2i, VA Palo Alto Health Care System, Menlo Park, CA.
Abstract
OBJECTIVE:
To test the effectiveness of a collaborative depression care model in improving depression and hepatitis C virus (HCV) care.
DATA SOURCES/STUDY SETTING:
Hepatitis C virus clinic patients who screened positive for depression at four Veterans Affairs Hospitals.
STUDY DESIGN:
We compared off-site depression collaborative care (delivered by depression care manager, pharmacist, and psychiatrist) with usual care in a randomized trial. Primary depression outcomes were treatment response (≥50 percent decrease in 20-item Hopkins Symptoms Checklist [SCL-20] score), remission (mean SCL-20 score, <0.5), and depression-free days (DFDs). Primary HCV outcome was receipt of HCV treatment.
DATA COLLECTION:
Patient data were collected by self-report telephone surveys at baseline and 12 months, and from electronic medical records.
PRINCIPAL FINDINGS:
Baseline screening identified 292 HCV-infected patients with depression, and 242 patients completed 12-month follow-up (82.9 percent). Intervention participants were more likely to report depression treatment response, remission, and more DFDs than usual care participants. Intervention participants were more likely to receive antiviral treatment; however, the difference was not statistically significant.
CONCLUSION:
Off-site depression collaborative care improved depression outcomes in HCV patients and may serve as a model for collaboration between mental health and specialty physical health providers in other high co-occurring conditions.