Telephone screening, outreach, and care management for depressed workers and impact on clinical and work productivity outcomes: a randomized controlled trial.

Telephone screening, outreach, and care management for depressed workers and impact on clinical and work productivity outcomes: a randomized controlled trial. Research Abstract Details 

Research Abstract Table of Contents

Jump to the:

Telephone screening, outreach, and care management for depressed workers and impact on clinical and work productivity outcomes: a randomized controlled trial. Abstract Text:

Kenneth B Wells,Jeanne Miranda,

CONTEXT: Although guideline-concordant depression treatment is clearly effective, treatment often falls short of evidence-based recommendations. Organized depression care programs significantly improve treatment quality, but employer purchasers have been slow to adopt these programs based on lack of evidence for cost-effectiveness from their perspective. OBJECTIVE: To evaluate the effects of a depression outreach-treatment program on workplace outcomes, a concern to employers. DESIGN, SETTING, AND PARTICIPANTS: A randomized controlled trial involving 604 employees covered by a managed behavioral health plan were identified in a 2-stage screening process as having significant depression. Patient treatment allocation was concealed and assessment of depression severity and work performance at months 6 and 12 was blinded. Employees with lifetime bipolar disorder, substance disorder, recent mental health specialty care, or suicidality were excluded. INTERVENTION: A telephonic outreach and care management program encouraged workers to enter outpatient treatment (psychotherapy and/or antidepressant medication), monitored treatment quality continuity, and attempted to improve treatment by giving recommendations to providers. Participants reluctant to enter treatment were offered a structured telephone cognitive behavioral psychotherapy. MAIN OUTCOME MEASURES: Depression severity (Quick Inventory of Depressive Symptomatology, QIDS) and work performance (World Health Organization Health and Productivity Questionnaire [HPQ], a validated self-report instrument assessing job retention, time missed from work, work performance, and critical workplace incidents). RESULTS: Combining data across 6- and 12-month assessments, the intervention group had significantly lower QIDS self-report scores (relative odds of recovery, 1.4; 95% confidence interval, 1.1-2.0; P = .009), significantly higher job retention (relative odds, 1.7; 95% confidence interval, 1.1-3.3; P = .02), and significantly more hours worked among the intervention (beta=2.0; P=.02; equivalent to an annualized effect of 2 weeks of work) than the usual care groups that were employed. CONCLUSIONS: A systematic program to identify depression and promote effective treatment significantly improves not only clinical outcomes but also workplace outcomes. The financial value of the latter to employers in terms of recovered hiring, training, and salary costs suggests that many employers would experience a positive return on investment from outreach and enhanced treatment of depressed workers. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00057590.

Telephone screening, outreach, and care management for depressed workers and impact on clinical and work productivity outcomes: a randomized controlled trial. Publishing Authors By Initials

KB Wells,J Miranda,

For similar geographic locations: americas: north america: united states research abstracts see: geographic locations: americas: north america: united states research

PUBMED ID PMID:

MEDLINE DATE:

Telephone screening, outreach, and care management for depressed workers and impact on clinical and work productivity outcomes: a randomized controlled trial. Journal Published:

PUBLICATION TYPE: Research Support, Non-U.S. Gov

Journal: JAMA : the journal of the American Medical Associa

VOLUME: 298

Page Numbers: 1401-11

Journal Abbreviation: JAMA

ISSN: 1538-3598

DAY: 26

MONTH: Sep

YEAR: 2007

Telephone screening, outreach, and care management for depressed workers and impact on clinical and work productivity outcomes: a randomized controlled trial. Information

Number of References:

LANGUAGE: eng

NlmUniqueID: 7501160

Telephone screening, outreach, and care management for depressed workers and impact on clinical and work productivity outcomes: a randomized controlled trial. Keywords Mesh Terms:

KEYWORDS: United States

MESH TERMS: utilization

Chemical & Substance for Abstract: Telephone screening, outreach, and care management for depressed workers and impact on clinical and work productivity outcomes: a randomized controlled trial. Information

Substance Name: Antidepressive Agents

Registry Number: 0

Grant and Affiliation Information for Telephone screening, outreach, and care management for depressed workers and impact on clinical and work productivity outcomes: a randomized controlled trial.

AFFILIATION: Division of Services and Intervention Research, National Institute of Mental Health, Rockville, Maryland, USA. wangphi@mail.nih.gov

Country: United States

AGENCY: United States NIMH

GRANT: R01 MH61941

ACRONYM: MH

MEDLINETA: JAMA

REFSOURCE: JAMA. 2007 Sep 26;298(12):1451-2

DATABASENAME:

ACCESSION NUMBER:

Number Hits: 0

Telephone screening, outreach, and care management for depressed workers and impact on clinical and work productivity outcomes: a randomized controlled trial Related Publications

• About the suboccipital part of the vertebral artery and the neighboring bone-joint and nerve relationships.
• Arthritis and physical-mental comorbidity in metropolitan China.
• Broadening the definition of generalized anxiety disorder: effects on prevalence and associations with other disorders in the National Comorbidity Survey Replication.
• Changes in surgical therapy for Crohn's disease over 33 years: a prospective longitudinal study.
• Clinical differences among patients treated for mental health problems in general medical and specialty mental health settings in the National Comorbidity Survey Replication.
• Complete robotic-assistance during laparoscopic living donor nephrectomies: an evaluation of 38 procedures at a single site.
• Concordance of the Composite International Diagnostic Interview Version 3.0 (CIDI 3.0) with standardized clinical assessments in the WHO World Mental Health surveys.
• DSM-IV personality disorders in the National Comorbidity Survey Replication.
• Delay in initial treatment contact after first onset of mental disorders in metropolitan China.
• Developmental changes in progenitor cell responsiveness to bone morphogenetic proteins differentially modulate progressive CNS lineage fate.
• Developmental changes in progenitor cell responsiveness to cytokines.
• Dual function of Sox1 in telencephalic progenitor cells.
• FoxD3 and Grg4 physically interact to repress transcription and induce mesoderm in Xenopus.
• FoxD3 regulation of Nodal in the Spemann organizer is essential for Xenopus dorsal mesoderm development.
• Lifetime prevalence and inter-cohort variation in DSM-IV disorders in metropolitan China.
• Lifetime prevalence, correlates, and persistence of oppositional defiant disorder: results from the National Comorbidity Survey Replication.
• Mental disorders among English-speaking Mexican immigrants to the US compared to a national sample of Mexicans.
• Mental health service use among hurricane Katrina survivors in the eight months after the disaster.
• Multiple congenital coagulopathies co-expressed with Von Willebrand's disease: the experience of Hemophilia Region III Treatment Centers over 25 years and review of the literature.
• Pharmacology of ampakine modulators: from AMPA receptors to synapses and behavior.
• Postcircumcision necrosis of the glans penis: gray-scale and color Doppler sonographic findings.
• Prevalence of the EH1 Groucho interaction motif in the metazoan Fox family of transcriptional regulators.
• Psychiatric epidemiology: challenges and opportunities.
• Risk for psychiatric disorder among immigrants and their US-born descendants: evidence from the National Comorbidity Survey Replication.
• Sonic hedgehog and BMP2 exert opposing actions on proliferation and differentiation of embryonic neural progenitor cells.
• Telephone screening, outreach, and care management for depressed workers and impact on clinical and work productivity outcomes: a randomized controlled trial.
• The costs and benefits of enhanced depression care to employers.
• The impact of comorbidity of mental and physical conditions on role disability in the US adult household population.
• The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication.
• Understanding mental health treatment in persons without mental diagnoses: results from the National Comorbidity Survey Replication.