A Comparative Effectiveness Trial of Depression Collaborative Care: Subanalysis of Comorbid Anxiety

Abstract

The purpose of this exploratory subanalysis was to compare the effects of two depression quality improvement approaches on clinical outcomes and service utilization for individuals with comorbid depression/anxiety. This study used data from Community Partners in Care (CPIC), a cluster-randomized comparative effectiveness trial ( N = 1,018; depression = 360; comorbid depression/anxiety = 658). Each intervention arm received the same quality improvement materials, plus either technical support (Resources for Services, RS) or support for collaborative implementation planning (Community Engagement and Planning, CEP). For the comorbid depression/anxiety subgroup, the collaborative planning arm was superior at improving mental health-related quality of life and mental wellness, as well as decreasing behavioral hospitalizations and homelessness risk at 6 months. The effects were not significant at 12 months. A collaborative planning process versus technical support for depression quality improvement can have short-term effects on mental wellness and social determinants of health among those with comorbid depression/anxiety.

Homelessness Prevention Interventions for Single Adults at Risk of or Experiencing MEH: A Systematic Review on their Effectiveness

“…Most of the studies evaluated programmes that combined two or more interventions from various categories, illustrating the importance of multifaceted services combining different housing, support, and treatment options to meet a range of needs and facilitate housing stability. The joint-up coordination of programmes across sectors was found to have better efficacy on housing stability for this population than providing services in silos (Barcelo et al, 2019;Choi et al, 2019;Reid et al, 2021;Rosenheck et al, 1998;Springgate et al, 2018). Unfortunately, in practice organisations predominantly work in silos (Madoc-Jones et al, 2018;Rogers et al, 2020).…”

“…Mental health care formed a part or the whole of evaluated programmes or comparators in nine papers (Burnam et al, 1995;Barcelo et al, 2019;Choi et al, 2019;Chapleau et al, 2012;Gutman & Raphael-Greenfield, 2017;Kertesz et al, 2007;Milby et al, 2005;Milby et al, 2010;Springgate et al, 2018) and three systematic reviews (Boland et al, 2018;Keenan et al, 2020;Peng et al, 2020). Mental health interventions helped with mental illness management and recovery and form new behavioural patterns to live independently.…”

“…Most studies implemented them at a tertiary prevention level. Three papers on one study also implemented them at primary and secondary prevention level (Barcelo et al, 2019;Choi et al, 2019;Springgate et al, 2018).…”

“…Three papers investigated two different implementations of a depression quality improvement approach for individuals with depression and anxiety (Choi et al, 2019), Black and Latino minorities with depression/anxiety (Barcelo et al, 2019) and those with multiple chronic conditions (MCC) and depression/anxiety (Springgate et al, 2018). Both implementation approaches received resources on depression quality improvement treatments, but one also encouraged a cross-sector collaboration via biweekly meetings.…”

“…The cross-sector collaboration led to greater program and provider participation in depression trainings and greater use of therapeutic practices and time spent delivering community services. Choi et al (2019) found that the cross-sector collaboration approach was significantly better at reducing the risk of homelessness at 6 months (OR: 0.51, 95% CI [0.31, 0.86]), but not at 12 months. This was true for the two analysed subgroups as well (Black/Latino 6-month OR: 0.65, 95% CI: [0.25, 0.92] ( Barcelo et al, 2019), MCC 6-month OR: 0.47, 95% CI [0.30, 0.72] (Springgate et al, 2018)).…”