This article is more than 5 years old. Information may no longer be current.

Symptom monitoring plus care management more effective for depression, anxiety in older adults

Results from a randomized clinical trial indicated that a more intense level of mental health care consisting of symptom monitoring plus care management was more effective among older adults with symptoms of depression and anxiety.

“One in five older adults experiences some form of [mental health] condition, but less than 10% report receiving any [mental health] treatment. Among those who seek or receive treatment, most do so when in primary care,” Shahrzad Mavandadi, PhD, of the Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, and colleagues wrote. “The evidence base for measurement-based, collaborative [mental health] care models is strong. However, although measurement-based [mental health] care management programs offer decision support and reduce the treatment heterogeneity that often characterizes [mental health] care, questions remain regarding the relative effectiveness of different treatment strategies for various populations.”

Researchers randomly assigned 1,018 older, community-dwelling, low-income adults to one of two treatment arms of varying intensity of the Supporting Seniors Receiving Treatment (SUSTAIN) program. SUSTAIN is an evidence-based, collaborative mental health care management service that provides software-aided mental health assessment and symptom monitoring and connection to community resources. Study participants were prescribed an antidepressant or anxiolytic by a primary care doctor or nonmental health professional and experienced clinically significant mental health symptoms at intake. One treatment group received monitoring alone (n = 509) and the other received care management delivered by a mental health professional (n = 509). Mental health outcomes were assessed at 3-month and 6-month follow-up.

Participants who received care management exhibited greater improvements in overall mental health functioning (P = .004), depressive symptoms (P < .001) and anxiety symptoms (P < .001) over time compared with those who received monitoring alone.

“The findings suggest that effective [mental health care management] strategies can be delivered across a large geographical region in a scalable manner using informatics support and available individual data for case finding,” the researchers wrote. “Moreover, the study results demonstrate that an enhanced [care management] program of evidence-based, collaborative care designed to address multiple [mental health] symptoms and non[mental health] needs and provide access to [mental health] health care professionals is associated with better outcomes compared with symptom [monitoring alone].” – by Amanda Oldt

Disclosure: The researchers report no relevant financial disclosures.