Patient Engagement Programs for Recognition and Initial Treatment of Depression in Primary Care A Randomized Trial

摘要

RESULTS Of the 925 eligible patients, 867 were included in the primary analysis (depressed, 559; nondepressed, 308). Among depressed patients, rates of achieving the primary outcome were 17.5% for DEV, 26% for IMCP, and 16.3% for control (DEV vs control, 1.1 [95% Cl, -6.7 to 8.9], P = .79; IMCP vs control, 9.9 [95% Cl, 1.6 to 18.2], P = .02). There were no effects on PHQ-8 measured depression score at the 12-week follow-up: DEV vs control, -0.2 (95% Cl, -1.2 to 0.8); IMCP vs control, 0.9 (95% Cl, -0.1 to 1.9). Among nondepressed patients, clinician-reported antidepressant prescribing in the DEV and IMCP groups was noninferior to control (mean percentage point difference [PPD]: DEV vs control, -2.2 [90% Cl, -8.0 to 3.49], P = .0499 for noninferiority; IMCP vs control, -3.3 [90% Cl, -9.1 to 2.4], P = .02 for noninferiority); patient-reported antidepressant recommendation did not achieve noninferiority (mean PPD: DEV vs control, 0.9 [90% Cl, -4.9 to 6.7], P = .23 for noninferiority; IMCP vs control, 0.3 [90% Cl, -5.1 to 5.7], P = .16 for noninferiority).