Does minority racial-ethnic status moderate outcomes of collaborative care for depression?

Davis TD, Deen T, Bryant-Bedell K, Tate V, Fortney J. Does minority racial-ethnic status moderate outcomes of collaborative care for depression? Psychiatric services (Washington, D.C.). 2011 Nov 1; 62(11):1282-8.

Related HSR&D Project(s)

• IIR 00-078 – Telemedicine Intervention to Improve Depression Care in Rural CBOCs

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Abstract:

OBJECTIVE: The authors examined racial differences in response rates to an intervention involving collaborative care and usual care among 360 veterans treated for depression at Department of Veterans Affairs community-based primary care clinics. METHODS: Individuals who screened positive for depression were assigned randomly to usual care (N = 200) or to a collaborative care intervention (N = 160) that provided phone contact when necessary with a registered nurse and clinical pharmacist to address issues related to compliance with medication and side effect management as well as supervision by a psychiatrist through video chats with the collaborative care team. Data about patients' characteristics, treatment history, and response to treatment were collected by telephone at baseline and after six months. RESULTS: Seventy-five percent (N = 272) of the veterans were Caucasian, and 25% (N = 88) belonged to a minority group, including 18% (N = 64) who were African American, 3% (N = 11) who were Native American, and 3.6% (N = 13) who were of other minority groups. There were no significant differences between response rates between the Caucasian and minority group to usual care (18% and 8%, respectively), but the minority group had a higher response rate (42%) than Caucasians (19%) to the intervention (? = 8.2, df = 1, p = .004). Regression analysis indicated that the interaction of minority group status by intervention significantly predicted response (odds ratio [OR] = 6.2, 95% confidence interval [CI] = 1.6-24.5, p = .009), even after adjustment for other factors associated with minority status (OR = 6.0, 95% CI = 1.5-24.3, p = .01). CONCLUSIONS: Racial disparities in depression care may be ameliorated through collaborative care programs.