An 18-month study of more than 700 patients enrolled in the Depression in Primary Care intervention at primary care practices in Michigan showed patients fared better in comparison to controls, according to Michael Klinkman, MD, of the University of Michigan in Ann Arbor, and colleagues. 

With the Chronic Care Model as its base, the intervention revolved around central care managers working in each primary care site.  These were either registered nurses or master’s in social work-level practitioners, with experience in providing mental health services.  Patients with known depression were identified by the practice, and referred to care managers who contacted them via a phone call to assess depression severity, and to introduce an educational curriculum focused on self-management of depression. The care managers followed all patients for up to 18 months with calls of varying frequency depending the severity of depression.  Outcome measures included remission and serial change seen in Patient Health Questionnaire (PHQ-8) scores.

"We conclude that a low-intensity, tailored care management program based on the Chronic Care Model can lead to sustainable improvement in care for depression for chronically depressed patients found in real-world primary care practices," Klinkman and co-authors reported in the September/October issue of the Annals of Family Medicine.

Effective Blood Pressure Control and the Chronic Care Model

Over the last few decades, an increasing number of health services research studies have examined the impact of office practices on achievement of blood pressure (BP) control:  supporting patient self-management, a team approach to patient care, technology-supported systems, better methods to measure adherence, and reduced clinical inertia.