Objective: The purpose of this study was to explore the efficacy of a primary care based on a telephone based disease management program for the acute management of depression and/or at-risk drinking.
Design: Subjects (n=97) with depression and/or at-risk drinking were identified by systematic screening and assessment. Eligible subjects received either a telephone disease management (TDM) program or usual care based on random assignment of their clinician. The TDM program consisted of regular contacts with each subject by a behavioral health specialist (BHS) in order to assist in assessment, education, support, and treatment planning. Symptomatic outcomes were assessed at 4 months.
Results: Overall response rates favored those assigned to TDM compared to those assigned to usual care (39.1% responded vs. 17.6%, p=0.022). Response rates within the separate diagnostic groups also favored TDM but this was only significant for depressive disorders.
Conclusion: Although the sample size was modest, findings strongly suggest that a telephone based disease management program can improve outcomes for patients suffering from a behavioral health problem. Findings also suggest that a health specialist can focus and manage patients with different diagnoses thus expanding the role beyond just depression care. TDM may be a viable, low cost, model for primary care clinicians to deliver manualized guideline adherent behavioral health care.
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