Rojas G, Guajardo V, Martínez P, et al. (2018). A remote collaborative care program for patients with depression living in rural areas: Open-label trial. Journal of Medical Internet Research. 20(4): e158. doi: 10.2196/jmir.8803
Researchers developed a collaborative care program for treating primary care patients with depression in rural areas to augment primary care based on national clinical practice guidelines for treating depression. The collaborative care program involved communication between rural primary care teams and university-based mental health teams to enhance depression treatment. Primary care teams provided national guideline adherent care and called patients every 1-2 weeks to monitor depression treatment adherence. Mental health teams tracked patient progress though shared health records and phone calls with primary care teams and made recommendations for depression treatment. To evaluate the collaborative care model, researchers recruited by clinician referral 250 patients newly diagnosed with depression from 15 rural Chilean community hospitals. Patients were randomized to receive national clinical practice guideline adherent primary care as usual or collaborative care for depression. Participants completed assessments of depression, health-related quality of life, treatment adherence, and depression treatment satisfaction at baseline, 3, and 6 months. There were no significant differences between groups in depression symptoms or physical-health related quality of life. Participants who received collaborative care reported higher mental health-related quality of life at 3 months relative to the usual care group; these differences were not maintained at 6 months. Treatment adherence and satisfaction were higher in the collaborative care group than in the usual care group at 6 months.