The Gerontologist
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
 QUICK SEARCH:   [advanced]


     


This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Gum, A. M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Gum, A. M.
The Gerontologist 46:14-22 (2006)
© 2006 The Gerontological Society of America

Depression Treatment Preferences in Older Primary Care Patients

Amber M. Gum, PhD1, Patricia A. Areán, PhD2, Enid Hunkeler, MA3, Lingqi Tang, PhD4, Wayne Katon, MD5, Polly Hitchcock, PhD6, David C. Steffens, MD7, Jeanne Dickens, MD8, Jürgen Unützer, MD, MPH4 and for the IMPACT Investigators

Correspondence: Address correspondence to Amber M. Gum, PhD, Department of Aging and Mental Health, University of South Florida, 13301 Bruce B. Downs Blvd., MHC 1400, Tampa, FL 33612. E-mail: agum{at}fmhi.usf.edu

Purpose: For depressed older primary care patients, this study aimed to examine (a) characteristics associated with depression treatment preferences; (b) predictors of receiving preferred treatment; and (c) whether receiving preferred treatment predicted satisfaction and depression outcomes. Design and Methods: Data are from 1,602 depressed older primary care patients who participated in a multisite, randomized clinical trial comparing usual care to collaborative care, which offered medication and counseling for up to 12 months. Baseline assessment included demographics, depression, health information, prior depression treatment, potential barriers, and treatment preferences (medication, counseling). At 12 months, services received, satisfaction, and depression outcomes were assessed. Results: More patients preferred counseling (57%) than medication (43%). Previous experience with a treatment type was the strongest predictor of preference. In addition, medication preference was predicted by male gender and diagnosis of major depression (vs dysthymia). The collaborative care model greatly improved access to preferred treatment, especially for counseling (74% vs 33% in usual care). Receipt of preferred treatment did not predict satisfaction or depression outcomes; these outcomes were most strongly impacted by treatment condition. Implications: Many depressed older primary care patients desire counseling, which is infrequently available in usual primary care. Discussion of treatment preferences should include an assessment of prior treatment experiences. A collaborative care model that increases collaboration between primary care and mental health professionals can increase access to preferred treatment. If preferred treatment is not available, collaborative care still results in good satisfaction and depression outcomes.

Key Words: Treatment preferences • Depression • Primary care • Collaborative care • Counseling




This article has been cited by other articles:


Home page
J. Gerontol. B Psychol. Sci. Soc. Sci.Home page
A. E. Hanson and F. Scogin
Older Adults' Acceptance of Psychological, Pharmacological, and Combination Treatments for Geriatric Depression
J. Gerontol. B. Psychol. Sci. Soc. Sci., July 1, 2008; 63(4): P245 - P248.
[Abstract] [Full Text] [PDF]


Home page
GerontologistHome page
P. Arean, M. Hegel, S. Vannoy, M.-Y. Fan, and J. Unuzter
Effectiveness of Problem-Solving Therapy for Older, Primary Care Patients With Depression: Results From the IMPACT Project
Gerontologist, June 1, 2008; 48(3): 311 - 323.
[Abstract] [Full Text] [PDF]


Home page
GerontologistHome page
S. Meeks, S. W. Looney, K. Van Haitsma, and L. Teri
BE-ACTIV: A Staff-Assisted Behavioral Intervention for Depression in Nursing Homes
Gerontologist, February 1, 2008; 48(1): 105 - 114.
[Abstract] [Full Text] [PDF]


Home page
FocusHome page
M. E. Thase, E. S. Friedman, M. M. Biggs, S. R. Wisniewski, M. H. Trivedi, J. F. Luther, M. Fava, A. A. Nierenberg, P. J. McGrath, D. Warden, et al.
Cognitive Therapy Versus Medication in Augmentation and Switch Strategies as Second-Step Treatments: A STAR*D Report
Focus, January 1, 2008; 6(1): 104 - 119.
[Abstract] [Full Text] [PDF]


Home page
Am. J. PsychiatryHome page
A. L. SERITAN
The Loss of Sadness: How Psychiatry Transformed Normal Sorrow Into Depressive Disorder
Am J Psychiatry, November 1, 2007; 164(11): 1764 - 1765.
[Full Text] [PDF]


Home page
AJGPHome page
D. D. Caudle, A. C. Senior, J. L. Wetherell, H. M. Rhoades, J. G. Beck, M. E. Kunik, A. L. Snow, N. L. Wilson, and M. A. Stanley
Cognitive Errors, Symptom Severity, and Response to Cognitive Behavior Therapy in Older Adults With Generalized Anxiety Disorder
Am J Geriatr Psychiatry, August 1, 2007; 15(8): 680 - 689.
[Abstract] [Full Text] [PDF]


Home page
Am. J. PsychiatryHome page
M. E. Thase, E. S. Friedman, M. M. Biggs, S. R. Wisniewski, M. H. Trivedi, J. F. Luther, M. Fava, A. A. Nierenberg, P. J. McGrath, D. Warden, et al.
Cognitive Therapy Versus Medication in Augmentation and Switch Strategies as Second-Step Treatments: A STAR*D Report
Am J Psychiatry, May 1, 2007; 164(5): 739 - 752.
[Abstract] [Full Text] [PDF]


Home page
Evid. Based Ment. HealthHome page
A. J Mitchell
Review: pharmacotherapy and psychotherapy similarly effective for depression in older adults
Evid. Based Ment. Health, May 1, 2007; 10(2): 50 - 50.
[Full Text] [PDF]




HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
All GSA journals Journals of Gerontology Series A: Biological Sciences and Medical Sciences Journals of Gerontology Series B: Psychological Sciences and Social Sciences
Copyright © 2006 by The Gerontological Society of America.