Provide feedbackProvide feedback

« Back

IMPACT depression model twice as effective as usual care, successfully implemented in some organizations

Thursday, May 10 2007 | Comments
Evidence Grade 0 What's This?
The IMPACT model of depression care appears to double the effectiveness of care, increase the number of depression-free days, and improve physical and social functioning relative to usual care, researchers from the University of Washington suggest.

"It's a flexible and adaptable program to treat late-life depression in a collaborative way," Melinda Hantke, one of the researchers, told VerusMed. "We use care managers to go in and have a lot of contact with the patients, and it's helped them in the process of getting better ... professional care."

In 2002, a study of the IMPACT program was published in JAMA; researchers led by Dr. Jurgen Unutzer randomized 1,801 patients aged 60 years or older from 18 primary care clinics to receive either IMPACT care or usual care. For IMPACT care, patients were assigned to a care manager (usually a nurse or social worker) and a consulting psychiatrist, who measured patients' depressive symptoms, monitored treatment efficacy, adjusted treatments to gain a sufficient response, and created a relapse prevention plan.

Results of the study showed that the IMPACT model doubled the effectiveness of depression treatment as compared with usual care, allowed patients to experience more than 100 additional depression-free days during a 2-year period as compared with usual care, substantially improved physical and social function and quality of life, and reduced chronic pain.

Due to the results of this study, researchers were given a grant to disseminate the program, which has in recent years been expanded and adapted by several organizations, including Kaiser Permanente of Southern California and the Institute for Urban Family Health in New York.

When a study was conducted of Kaiser Permanente's program, which included all adults with depression, the effects on depression were shown to be equal to those seen in the first study.

In addition, an analysis of the program at the Institute for Urban Family Health found that the scores on the 9-item depression scale of the Patient Health Questionnaire at 6 months decreased dramatically from baseline for patients with severe depression (score, >=20), moderately severe depression (score, 15 to 19), and moderate depression (score, 10 to 14). (Unutzer J, et al. Poster C108.)

Print  |  E-mail


Be the first to write a comment for this article!

You must be logged in to post a comment.