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Health Care System Changes to Improve Adherence and Long-Term Outcomes for Depressed Patients
Published online by Cambridge University Press: 07 November 2014
Extract
Depression, which is increasingly regarded as a chronic condition, is associated with significant suffering, social and functional impairment, and an estimated $44 billion in direct and indirect costs annually in the United States. Despite this severe burden on the health care system, the management of depression remains suboptimal in primary care, where many depressed patients fail to receive adequate dosage and duration of treatment. Adherence to evidence-based guidelines, essential to improving outcomes, requires key structural changes to the US health care delivery system. Several health care models aimed at improving treatment adherence in patients with chronic illnesses have been evaluated in primary care settings with promising results. Those approaches that have been found to be effective advocate multifaceted collaborative interventions that target patients, families, physicians, and the organization of the health care system to improve adherence and depression outcomes. Enhancing education and the active participation of patients and their families are now considered important elements of interventions to improve adherence to the treatment of chronic illnesses, including depression.
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