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Collaborative Care is an Evidence Based Treatment Model for Depression and Anxiety

Posted By Pamela Williams, Thursday, November 22, 2012

As readers of this blog are well aware, depression and anxiety "are a major cause of disease burden and disability with depression projected to become one of the three leading causes of burden of disease by 2030.” It is estimated that 90% of people who suffer from depression and anxiety are treated solely by their primary care physician, and the majority of these interventions are exclusively pharmacological. Many people also report being unsatisfied with the level of care they receive. While these facts point toward collaborative care being a logical and effective treatment model for depression and anxiety, there was not enough research that provided conclusive evidence to support recommending collaborative care for those with depression and anxiety problems until this year. 

A recent review summarized in the Cochrane Library and authored by Janine Archer, Ph.D. of the school of Nursing, Midwifery and Social work at The University of Manchester in the U.K. provides promising results for collaborative care as an evidence based treatment for anxiety and depression. Reviews from the Cochrane Library are widely considered the gold standard of evidence-based medicine.

As described on the Cochrane website:

Cochrane Library Logo

"Collaborative care is associated with significant improvement in depression and anxiety
outcomes compared with usual care, and
represents a useful addition to clinical pathways
for adult patients with depression and anxiety.”

"Each systematic review addresses a clearly formulated question; for example: Can antibiotics help in alleviating the symptoms of a sore throat? All the existing primary research on a topic that meets certain criteria is searched for and collated, and then assessed using stringent guidelines, to establish whether or not there is conclusive evidence about a specific treatment."

The collaborative care review looked at seventy-nine randomized control trials (which included 24,308 patients) that compared the collaborative care treatment model with either standardized care or alternative treatments. The review required four key criteria to be considered part of the collaborative care model: 1) a multi-professional approach to patient care, 2) a structured management plan, 3) scheduled patient follow-ups, and 4) enhanced inter-professional communication.

The results suggest that "collaborative care is associated with significant improvement in depression and anxiety outcomes compared with usual care, and represents a useful addition to clinical pathways for adult patients with depression and anxiety.” Patients who were treated with a collaborative care model also reported being more satisfied with their level of treatment than their counterparts receiving standard or alternative care. Research increasingly supports a systemic approach to healthcare and a collaborative care model that also provides patients with a high level of satisfaction.

 

Pamela Williams
Pamela Williams is a graduate student at the University of San Diego obtaining her masters degree in marital and family therapy. She is passionate about collaborative care and working with families with young children and hopes to combine these two passions in her future work.
 

 Reference:

Archer J., Bower P., Gilbody S., Lovell K., Richards D., Gask L., Dickens C., Coventry P. (2012) Collaborative care for depression and anxiety problems. Cochrane Database of Systematic Reviews, 10. DOI:10.1002/14651858.CD006525.pub2.


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Comments on this post...

Matthew P. Martin says...
Posted Monday, November 26, 2012
This is very important research in providing evidence that collaboration works. Another part of the evolution in improving the health care system is showing that collaboration is cost-effective. I would LOVE to see a review of the research that examines the financial side of collaborative care. If anyone is looking for a good research/dissertation topic, that would be one to consider. Thanks for sharing Pamela.
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Travis A. Cos says...
Posted Monday, November 26, 2012
There actually have been some reviews on the cost-offset of collaboration. These include...
http://dcwww.pcpcc.net/files/organizing_the_evidence_0.pdf
http://www.thecommunityguide.org/mentalhealth/SETecon-collab-care.pdf
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