This is a revised application (original proposal, """"""""Pathways to Long-Term Outcomes in Depression""""""""). We propose to determine how remission from an initial depressive episode affects long-term (4-year follow-up) economic outcomes, including employment status and labor force participation outcomes, income, and wealth. If improving depressive illnesses also affects policy-relevant outcomes, then patients, practices, and providers may have increased incentives to commit to depression treatment and quality improvement programs. We also propose to estimate how short-term quality improvement programs affect these long-term economic outcomes and how appropriate treatment for depression, provided under naturalistic practice conditions, affects these outcomes. We propose to add four-year follow-up data collection (telephone interviews) for patients who participated in Partners in Care, an AHRQ/ MacArthur/ NIMH-funded Patient Outcomes Research Team (PORT-II). The parent study was a randomized trial of disseminating quality improvement interventions into diverse, nonacademic, community-based, managed, primary care practices in four geographic sites. The parent study evaluation included baseline and two-year follow-up data collector on patients who initially received care in primary care clinics randomized to usual care or one of two depression quality improvement interventions. The current study proposes to use the parent study's data and the new four-year follow-up data. The proposed analyses are a mix of experimental (intent-to- treat) and observational (instrumental variables, structural modeling, decision analysis) analyses. The interdisciplinary investigator team fielded the parent study.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH061570-02
Application #
6539106
Study Section
Special Emphasis Panel (ZMH1-CRB-H (03))
Program Officer
Oliver, Karen Anderson
Project Start
2001-04-20
Project End
2004-03-31
Budget Start
2002-04-01
Budget End
2003-03-31
Support Year
2
Fiscal Year
2002
Total Cost
$167,174
Indirect Cost
Name
Rand Corporation
Department
Type
DUNS #
City
Santa Monica
State
CA
Country
United States
Zip Code
90401
Miranda, Jeanne; Bromley, Elizabeth; Izquierdo, Adriana et al. (2017) Surviving Depression: Clinical Qualitative Analysis of Long-Term Survival for Ethnically Diverse, Depressed Patients. J Nerv Ment Dis 205:589-599
Bromley, Elizabeth; Kennedy, David; Miranda, Jeanne et al. (2016) The Fracture of Relational Space in Depression: Predicaments in Primary Care Help Seeking. Curr Anthropol 57:610-631
Klap, Ruth; Tang, Lingqi; Schell, Terry et al. (2009) How quality improvement interventions for depression affect stigma concerns over time: a nine-year follow-up study. Psychiatr Serv 60:258-61
Wells, Kenneth B; Tang, Lingqi; Miranda, Jeanne et al. (2008) The effects of quality improvement for depression in primary care at nine years: results from a randomized, controlled group-level trial. Health Serv Res 43:1952-74
Sherbourne, Cathy Donald; Edelen, Maria Orlando; Zhou, Annie et al. (2008) How a therapy-based quality improvement intervention for depression affected life events and psychological well-being over time: a 9-year longitudinal analysis. Med Care 46:78-84
Wells, Kenneth B; Sherbourne, Cathy D; Miranda, Jeanne et al. (2007) The cumulative effects of quality improvement for depression on outcome disparities over 9 years: results from a randomized, controlled group-level trial. Med Care 45:1052-9
Wells, Kenneth B; Miranda, Jeanne (2007) Reducing the burden of depression: building villages for coordinated care. JAMA 298:1451-2
Masaquel, Anthony; Wells, Kenneth; Ettner, Susan L (2007) How does the persistence of depression influence the continuity and type of health insurance and coverage limits on mental health therapy? J Ment Health Policy Econ 10:133-44
Watkins, Katherine E; Paddock, Susan M; Zhang, Lily et al. (2006) Improving care for depression in patients with comorbid substance misuse. Am J Psychiatry 163:125-32
Patel, Kavita K; Butler, Brittany; Wells, Kenneth B (2006) What is necessary to transform the quality of mental health care. Health Aff (Millwood) 25:681-93

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