In this issue of the ARCHIVES, Gilbody et al1 report a systematic review and meta-analysis of 37 randomized controlled trials that tested the effect of collaborative care models vs usual primary care treatment in 12 355 patients with depression. Collaborative care was found to increase adherence to antidepressant medication at 6 months by almost 2-fold and to result in improved depression outcomes at 6 months. In the 11 studies that reported long-term results, collaborative care was associated with improved depressive outcomes at 12, 18, and 24 months (although the 24-month comparison did not quite reach statistical significance) and in 1 large trial at 5 years. A strength of this meta-analysis was that it sought to better understand the heterogeneity of findings from the 37 trials. Collaborative care programs that had evidence of more robust improvements in depression outcomes were found to have the following: improvements in antidepressant medication adherence; care managers with more mental health training; and regular caseload supervision, in most cases by psychiatrists.
Thank you for submitting a comment on this article. It will be reviewed by JAMA Internal Medicine editors. You will be notified when your comment has been published. Comments should not exceed 500 words of text and 10 references.
Do not submit personal medical questions or information that could identify a specific patient, questions about a particular case, or general inquiries to an author. Only content that has not been published, posted, or submitted elsewhere should be submitted. By submitting this Comment, you and any coauthors transfer copyright to the journal if your Comment is posted.
* = Required Field
Disclosure of Any Conflicts of Interest*
Indicate all relevant conflicts of interest of each author below, including all relevant financial interests, activities, and relationships within the past 3 years including, but not limited to, employment, affiliation, grants or funding, consultancies, honoraria or payment, speakers’ bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. If all authors have none, check "No potential conflicts or relevant financial interests" in the box below. Please also indicate any funding received in support of this work. The information will be posted with your response.
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Web of Science® Times Cited: 50
Customize your page view by dragging & repositioning the boxes below.
More Listings atJAMACareerCenter.com >
The Rational Clinical Examination
Make the Diagnosis: Depression
The Rational Clinical Examination
Original Article: Is This Patient Clinically Depressed?
All results at
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.