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Follow-ups prove powerful tool for treating depression in primary care
Date:10/26/2010

ANN ARBOR, Mich. In the 15 minutes a primary care doctor typically has with a patient, she's expected to diagnose the current ailment, help manage ongoing health issues and provide preventive care. In this setting, confronting all but the most obvious and immediate mental health needs of patients is an ongoing challenge.

A new study by researchers at the University of Michigan Health System, however, points to an encouraging strategy for improving and sustaining mental health results in chronically depressed patients by providing small amounts of flexible, targeted follow-up care without overburdening busy doctors' offices.

The study, published in the September/October issue of Annals of Family Medicine, shows that patients who received interventions that included self-monitoring tools and follow-up phone calls from a care manager were more likely a year and a half later to have symptoms that were in remission and to have fewer reduced-function days than those receiving usual primary care treatment.

"They key is to keep patients engaged in treatment," says Michael Klinkman, M.D., M.S., a professor of family medicine at the University of Michigan Medical School and lead author of the study. "What it's not is telephone therapy. Patients have a human contact, somebody who can help them become more actively involved in their own care. It's hard to do that if you're just spoon feeding information to 'educate' a patient or telling them to go to a website."

With a more traditional approach that depends on a follow-up office visit, it might be months before a primary care doctor learns that his patient's depression is getting worse. And in many cases patients simply don't follow up.

For the study, a care manager worked in collaboration with doctors' practices, rather than on the side or independently, Klinkman says. That helps the family practice office to act as a home base for all of a patient's medical needs. Th
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Contact: Ian Demsky
idemsky@umich.edu
734-764-2220
University of Michigan Health System
Source:Eurekalert

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