Mental Health and Mental Illness: Interventions to Reduce Depression Among Older Adults Home-Based Depression Care Management
Findings and Recommendations
The Community Preventive Services Task Force (CPSTF) recommends depression care management at home for older adults with depression on the basis of strong evidence of effectiveness in improving short-term depression outcomes.
The CPSTF has related findings for the following interventions to reduce depression among older adults:
- Clinic-based depression care management (recommended)
- Community-based exercise interventions (insufficient evidence)
The full CPSTF Finding and Rationale Statement and supporting documents for Improving Mental Health and Addressing Mental Illness: Interventions to Reduce Depression among Older Adults, Home-Based Depression Care Management are available in The Community Guide Collection on CDC Stacks.
Intervention
Home-based depression care management involves:
- Active screening for depression
- Measurement-based outcomes
- Trained depression care managers providing case management in the home
- Primary care provider and patient education, antidepressant treatment and/or psychotherapy, and a supervising psychiatrist
An older adult is defined as 60 years of age or older.
About The Systematic Review
The CPSTF finding is based on evidence from a systematic review of 8 studies (search period 1967 — October 2005).
Study Characteristics
Not available because the CPSTF finding is based on a previously published systematic review (Frederick et al., 2007). Please refer to the article for more information.
Summary of Results
For the three studies reporting response and remission rates, there was a 27 43% response rate in depression and a 36% remission rate.
Summary of Economic Evidence
One study of a program with 19-weeks of home visits for Problem Solving Therapy, follow-up phone calls with the psychiatrist, quality control of psychotherapy by trainer, and depression management team sessions reported cost data. The total mean cost per patient for this program was $630. This data does not factor in any cost savings from the intervention, such as reductions in health care utilization.
Applicability
The evidence may be applicable to communities in the United States and elsewhere, including diverse home settings (public housing, residential facilities, home care clients) and participants ranging in age, health status, sex, race/ethnicity, education level, and living alone status.
Evidence Gaps
Not available because the CPSTF finding is based on a previously published systematic review (Frederick et al., 2007). Please refer to the article for more information.
Implementation Considerations and Resources
Not available because the CPSTF finding is based on a previously published systematic review (Frederick et al., 2007). Please refer to the article for more information.
Crosswalks
Healthy People 2030 includes the following objectives related to this CPSTF recommendation.