Rodger Kessler, PhD, ABPP, does a regular search of the Ovid database for useful citations and abstracts. Dr. Kessler is a Research Assistant Professor in the Department of Family Medicine, Center for Translational Science, at the University of Vermont College of Medicine. Here are his latest findings.
From: Ovid AutoAlert [mailto:autorun@ovid.com]
Sent: Friday, August 15, 2008 5:01 AM
Subject: Current Awareness KESSLER AutoAlert: KESSLER
Total documents retrieved: 3
Results Generated From:
Ovid MEDLINE(R) <2004 to August Week 1 2008> (updates since 2008-08-04)
Deduplicated against past 90 days of results.
Citation 1.
Unique Identifier
18597695
Status
MEDLINE
Authors
Younes N. Passerieux C. Hardy-Bayle MC. Falissard B. Gasquet I. .
Authors Full Name
Younes, Nadia. Passerieux, Christine. Hardy-Bayle, Marie-Christine. Falissard, Bruno. Gasquet, Isabelle. .
Institution
Academic Unit of Psychiatry, Versailles Hospital, Le Chesnay, France. nadia.younes@noos.fr
Title
Long term GP opinions and involvement after a consultation-liaison intervention for mental health problems.
Source
BMC Family Practice. 9:41, 2008.
Abstract
BACKGROUND:
Shared Mental Health care between Psychiatry and Primary care has been
developed to improve the care of common mental health problems but has
not hitherto been adequately evaluated. The present study evaluated a
consultation-liaison intervention with two objectives: to explore
long-term GP opinions (relating to impact on their management and on
patient medical outcome) and to determine the secondary referral rate,
after a sufficient time lapse following the intervention to reflect a
"real-world" primary care setting. METHODS: All the 139 collaborating
GPs (response rate: 84.9%) were invited two years after the
intervention to complete a retrospective telephone survey for each
patient (181 patients; response rate: 69.6%). RESULTS: 91.2% of GPs
evaluated effects as positive for primary care management (mainly as
support) and 58.9% noted positive effects for patient medical outcome.
Two years post-intervention, management was shared care for 79.7% of
patients (the GP as the psychiatric care provider) and care by a
psychiatrist for 20.3% patients. Secondary referral occurred finally in
44.2% of cases. CONCLUSION: The intervention supported GP partners in
their management of patients with common mental health problems.
Further studies are required on the appropriateness of the care
provider.
Publication Type
Evaluation Studies. Journal Article. Research Support, Non-U.S. Gov't. .
Citation 2.
Unique Identifier
18625920
Status
MEDLINE
Authors
Young HN. Bell RA. Epstein RM. Feldman MD. Kravitz RL. .
Authors Full Name
Young, Henry N. Bell, Robert A. Epstein, Ronald M. Feldman, Mitchell D. Kravitz, Richard L. .
Institution
Social
and Administrative Sciences Division, School of Pharmacy, University of
Wisconsin-Madison, Madison, USA. hnyoung@pharmacy.wisc.edu
Title
Physicians' shared decision-making behaviors in depression care.[see comment].
Comments
Comment in: Arch Intern Med. 2008 Jul 14;168(13):1368-70; PMID: 18625916
Source
Archives of Internal Medicine. 168(13):1404-8, 2008 Jul 14.
Abstract
BACKGROUND:
Although shared decision making (SDM) has been reported to facilitate
quality care, few studies have explored the extent to which SDM is
implemented in primary care and factors that influence its application.
This study assesses the extent to which physicians enact SDM behaviors
and describes factors associated with physicians' SDM behaviors within
the context of depression care. METHODS: In a secondary analysis of
data from a randomized experiment, we coded 287 audiorecorded
interactions between physicians and standardized patients (SPs) using
the Observing Patient Involvement (OPTION) system to assess physician
SDM behaviors. We performed a series of generalized linear mixed model
analyses to examine physician and patient characteristics associated
with SDM behavior. RESULTS: The mean (SD) OPTION score was 11.4 (3.3)
of 48 possible points. Older physicians (partial correlation
coefficient = -0.29; beta = -0.09; P < .01) and physicians who
practiced in a health maintenance organization setting (beta = -1.60; P
< .01) performed fewer SDM behaviors. Longer visit duration was
associated with more SDM behaviors (partial correlation coefficient =
0.31; beta = 0.08; P < .01). In addition, physicians enacted more
SDM behaviors with SPs who made general (beta = 2.46; P < .01) and
brand-specific (beta = 2.21; P < .01) medication requests compared
with those who made no request. CONCLUSIONS: In the context of new
visits for depressive symptoms, primary care physicians performed few
SDM behaviors. However, physician SDM behaviors are influenced by
practice setting and patient-initiated requests for medication.
Additional research is needed to identify interventions that encourage
SDM when indicated.
Publication Type
Journal Article. Randomized Controlled Trial. Research Support, N.I.H., Extramural. Research Support, Non-U.S. Gov't. .
Citation 3.
Unique Identifier
18332158
Status
MEDLINE
Authors
Katon WJ. Russo JE. Von Korff M. Lin EH. Ludman E. Ciechanowski PS. .
Authors Full Name
Katon, Wayne J. Russo, Joan E. Von Korff, Michael. Lin, Elizabeth H B. Ludman, Evette. Ciechanowski, Paul S. .
Institution
Department
of Psychiatry, University of Washington School of Medicine, Seattle,
Washington 98195-6560, USA. wkaton@u.washington.edu
Title
Long-term effects on medical costs of improving depression outcomes in patients with depression and diabetes.
Source
Diabetes Care. 31(6):1155-9, 2008 Jun.
Abstract
OBJECTIVE:
The purpose of this study was to examine the 5-year effects on total
health care costs of the Pathways depression intervention program for
patients with diabetes and comorbid depression compared with usual
primary care. RESEARCH DESIGN AND METHODS: The Pathways Study was
conducted in nine primary care practices of a large HMO and enrolled
329 patients with diabetes and comorbid major depression. The current
study analyzed the differences in long-term medical costs between
intervention and usual care patients. Participants were randomly
assigned to a nurse depression intervention (n = 164) or to usual
primary care (n = 165). The intervention included education about
depression, behavioral activation, and a choice of either starting with
support of antidepressant medication treatment by the primary care
doctor or problem-solving therapy in primary care. Interventions were
provided for up to 12 months, and the main outcome measures are health
costs over a 5-year period. RESULTS: Patients in the intervention arm
of the study had improved depression outcomes and trends for reduced
5-year mean total medical costs of -$3,907 (95% CI -$15,454 less to
$7,640 more) compared with usual care patients. A sensitivity analysis
found that these cost differences were largely explained by the
patients with depression and the most severe medical comorbidity.
CONCLUSIONS: The Pathways depression collaborative care program
improved depression outcomes compared with usual care with no evidence
of greater long-term costs and with trends for reduced costs among the
more severely medically ill patients with diabetes.
Publication Type
Journal Article. Randomized Controlled Trial. Research Support, N.I.H., Extramural. .