Collaborative Care Model for Depression More Effective than Monotherapy

Women treated for depression with collaborative care showed fewer symptoms after treatment than women who received traditional care, according to a study published in Obstetrics & Gynecology on May 7, 2014.

Researchers from the University of Washington in Seattle studied 205 women randomly assigned to either receive traditional or collaborative care interventions. Both groups received their respective treatments for up to 12 months with a ­6-month optional follow up that included phone calls, in-person visits, counseling, medication, or a combination of all of the options.

The researchers believe their study is the first of its kind to bring depression care to an obstetrics/gynecology (OB/GYN) or women’s health settings. The study notes that more than one-third of women list OB/GYNs as their primary care physician, including underserved women at a high risk for depression.

Nearly half of the women were women of color. The researchers believe the large Latina populations in Eastern Washington have trouble accessing mental health services. More than half of the participants were managing post-traumatic stress disorder (PTSD) as well as depressive symptoms.

One year after treatment, women who received collaborative care displayed decreased symptoms by about 50%. One women wrote the Depression Attention for Women Now (DAWN) approach “gave her the tools to manage her depression on her own,” according to a statement.

“Collaborative care benefits the community not only by helping women with depression regain function in their lives, but also by lowering healthcare costs,” said the study’s co-leader, Susan Reed, MD, MPH. “We anticipate fewer women will go to emergency rooms for acute care problems related to mental health, and more women will be able to rejoin the workforce.”

The researchers aim to continue to bring the DAWN approach and the collaborative care model to the Harborview Medical Center’s Women’s Clinic, where the trial took place over a year ago. Reed noted the collaborative care approach could be adopted for other types of specialty care.

“An integrated, collaborative, stepped care model for women with depression receiving care in obstetrics and gynecology clinics is feasible and significantly more effective than usual care in improving quality of mental health care, depressive and functional outcomes, and satisfaction with depression care, and can be provided at modest cost (not dissimilar to that of a pelvic magnetic resonance imaging [MRI]),” the authors conclude. “Improving mental health care provision in women’s health care settings has important implications for US families and society as a whole, particularly with the anticipated changes in health care delivery.”