TY - JOUR
T1 - Collaborative Health Literate Depression Care Among Predominantly Hispanic Patients With Coronary Heart Disease in Safety Net Care
AU - Ell, Kathleen
AU - Oh, Hyunsung
AU - Lee, Pey Jiuan
AU - Guterman, Jeffrey
N1 - Funding Information:
Acknowledgments: The pilot study was funded by the California Health Care Foundation USC IRB number USCIRB-HS-06-00420. (PI, Dr Ell).
PY - 2014
Y1 - 2014
N2 - Objective: To determine whether evidence-based socioculturally health literate-adapted collaborative depression care improves depression care, depressive symptoms, and quality of life among predominantly Hispanic patients with coronary heart disease. Methods: The 12-month trial included 97 patients with coronary heart disease (79% of eligible patients) who met the depression criteria assessed by the Patient Health Questionnaire-9. Patients were recruited from 3 safety net clinics and offered depression team care by a bilingual clinical social worker and community patient navigator, a consulting psychiatrist, and a primary care physician. The team provided problem-solving therapy (PST) or pharmacotherapy or both, telephone symptom monitoring and behavioral activation, and patient resource navigation support. Recruited patients were given patient and family member health literacy-adapted educational and community resource materials in Spanish or English. Results: Overall, depression treatment was 74% (PST, 55%; PST plus antidepressant medications, 18%; and antidepressant medications alone, 2%). Nearly half of the patients showed a 50% reduction of the Symptom Checklist-20 (49% at 6 mo and 48% at 12 mo) and of Patient Health Questionnaire-9 score with 47% of patients at 6 months and 43% at 12 months. The 50% improvement in Patient Health Questionnaire and Symptom Checklist-20 score reduction did not vary significantly between patients who received PST or antidepressant only or those who received PST plus antidepressant. The quality of life Short-Form Health Survey SF-12, the Minnesota Living with Heart Failure questionnaire, and the Sheehan Disability Scale outcomes also improved significantly. Conclusions: Socioculturally literacy-adapted collaborative depression care was accepted by patients with coronary heart disease and improved depression care and symptoms, quality of life, and functional outcomes among predominantly Hispanic patients with heart disease.
AB - Objective: To determine whether evidence-based socioculturally health literate-adapted collaborative depression care improves depression care, depressive symptoms, and quality of life among predominantly Hispanic patients with coronary heart disease. Methods: The 12-month trial included 97 patients with coronary heart disease (79% of eligible patients) who met the depression criteria assessed by the Patient Health Questionnaire-9. Patients were recruited from 3 safety net clinics and offered depression team care by a bilingual clinical social worker and community patient navigator, a consulting psychiatrist, and a primary care physician. The team provided problem-solving therapy (PST) or pharmacotherapy or both, telephone symptom monitoring and behavioral activation, and patient resource navigation support. Recruited patients were given patient and family member health literacy-adapted educational and community resource materials in Spanish or English. Results: Overall, depression treatment was 74% (PST, 55%; PST plus antidepressant medications, 18%; and antidepressant medications alone, 2%). Nearly half of the patients showed a 50% reduction of the Symptom Checklist-20 (49% at 6 mo and 48% at 12 mo) and of Patient Health Questionnaire-9 score with 47% of patients at 6 months and 43% at 12 months. The 50% improvement in Patient Health Questionnaire and Symptom Checklist-20 score reduction did not vary significantly between patients who received PST or antidepressant only or those who received PST plus antidepressant. The quality of life Short-Form Health Survey SF-12, the Minnesota Living with Heart Failure questionnaire, and the Sheehan Disability Scale outcomes also improved significantly. Conclusions: Socioculturally literacy-adapted collaborative depression care was accepted by patients with coronary heart disease and improved depression care and symptoms, quality of life, and functional outcomes among predominantly Hispanic patients with heart disease.
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U2 - 10.1016/j.psym.2014.03.007
DO - 10.1016/j.psym.2014.03.007
M3 - Article
C2 - 25262042
AN - SCOPUS:84926291556
SN - 0033-3182
VL - 55
SP - 555
EP - 565
JO - Psychosomatics
JF - Psychosomatics
IS - 6
ER -