Interventions to Reduce Depression Among Older Adults: Home-Based Depression Care Management

Home-based depression care management involves:

• Active screening for depression
• Measurement-based outcomes
• Trained depression care managers
• Case management
• Patient education, and a
• Supervising psychiatrist

An older adult is defined as 60 years of age or older, and depression outcomes include response rates (50% reduction in depression scores), remission (no longer meeting diagnostic criteria), and changes in depression scale scores.

Summary of Task Force Recommendations & Findings

The Community Preventive Services Task Force recommends depression care management at home for older adults with depression on the basis of strong evidence of effectiveness in improving short-term depression outcomes.

Results of the Systematic Reviews

• For the three studies reporting response and remission rates, there was a 27–43% response rate in depression and a 36% remission rate.
• The evidence may be applicable to communities in the United States and elsewhere, including diverse home settings (public housing, residential facilities, home care clients) and participants ranging in age, health status, gender race/ethnicity, education level, and living alone status.
• One study of a program with 19-weeks of home visits for Problem Solving Therapy, follow-up phone calls with the psychiatrist, quality control of psychotherapy by trainer, and depression management team sessions reported cost data. The total mean cost per patient for this program was $630. This data does not factor in any cost savings from the intervention, such as reductions in health care utilization.

These results were based on a systematic review of all available studies that met review criteria by a team of specialists in systematic review methods, and experts in research, practice, and policy from the Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine.

Publications

Frederick JT, Steinman LE, Prohaska T, et al. Community-based treatment of late life depression—an expert panel informed literature review. Am J Prev Med 2007;33(3):222–49.

Steinman LE, Frederick JT, Prohaska T, et al. Recommendations for treating depression in community-based older adults. Am J Prev Med 2007:33(3):175-81.

Snowden M, Steinman L, Frederick J. Treating depression in older adults: challenges to implementing the recommendations of an expert panel. Prev Chronic Dis 2008;5(1):A26.

More Community Guide publications about Mental Health & Mental Illness

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Sample Citation

The content of publications of the Guide to Community Preventive Services is in the public domain. Guide to Community Preventive Services. Interventions to reduce depression among older adults: home-based depression care management. www.thecommunityguide.org/mentalhealth/depression-home.html. Last updated: MM/DD/YYYY.

Review completed: February 2008