Generalist Care Managers for Treating Depression in Medicaid Patients
Author Information
Author(s): Landis Suzanne E, Gaynes Bradley N, Morrissey Joseph P, Vinson Nina, Ellis Alan R, Domino Marisa E
Primary Institution: University of North Carolina, Chapel Hill, NC, USA
Hypothesis
Can generalist care managers improve outcomes for depressed Medicaid patients compared to usual care?
Conclusion
Generalist care managers can be trained to manage depression and other chronic illnesses, but they did not show better outcomes than usual care in this pilot study.
Supporting Evidence
- Both groups improved, but the GCM group did not show better clinical outcomes than the UC group.
- GCMs recorded an average of 46 interactions per patient.
- Patients in the GCM group were more likely to have prescriptions of correct dosing.
- Focus group data showed that physicians valued using GCMs.
Takeaway
This study looked at whether generalist care managers could help people with depression. They were trained to help, but the results were similar to regular care.
Methodology
Patients were randomized to receive care from generalist care managers or usual care, with various measures taken at baseline, 3 months, and 6 months.
Potential Biases
Potential bias due to the awareness of physicians about the study and their involvement in both treatment arms.
Limitations
The study had a small sample size and may not have had enough power to detect differences.
Participant Demographics
Participants were mostly female (95.6%), with a median age of 40, primarily White (62.2%), and many had low educational status.
Statistical Information
P-Value
p = 0.09 for mental health improvement in usual care group.
Confidence Interval
95% CI 0.79 to 0.95 for screening effectiveness.
Digital Object Identifier (DOI)
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