A new study from Regenstrief Institute, Indiana University Center for Aging Research, IU Center for Health Innovation and Implementation Science, and Eskenazi Health resulted in lowered depression severity by more than 50 percent over six months.
The effort, Aging Brain Care Medical Home – ABC for short – is a new brain-focused population health management program implemented in the homes of older adults.
The ABC Medical Home program runs with a trained and scalable workforce of care coordinator assistants. They form the core of and interdisciplinary care team of nurses, social workers, and physicians, all responsible for meeting the complex biopsychosocial brain-care needs of older adults.
"Response to Depression Treatment in the Aging Brain Care Medical Home Model" is published online in Clinical Interventions in Aging, a peer-reviewed open access journal.
The implementation study provides strong evidence of the sustained effectiveness of the
A study of the initiative revealed that the ABC Medical Home program demonstrated sustained effectiveness at lowering depression by employing a workforce that develops long-term relationships with the patients through home visits and telephone contacts.
The more than 50 percent decrease in depression symptoms occurred in individuals with high levels of the symptoms. While women experienced improvement sooner than men, there was no gender difference in decrease of the symptons at the end of six months.
In older adults with low levels of depression, depression scores remained low over time indicating that the care model prevented depression symptoms from recurring.
[See also: Regenstrief Institute selects Ohio State’s Peter Embi for CEO post.]
Michael LaMantia, M.D., MPH, first author of the new study, offers the following analogy to explain the different responses of older adults with high levels of depressive symptoms and those with low levels. "If you have people who are driving a car at 60 miles per hour, these drivers have a lot of room to decelerate over time because they are going at a high speed; similarly there is significant room for symptom decease in those with high symptom levels; but for those with low depressive symptom levels, like those drivers traveling 5 or 10 miles per hour, there isn't a whole lot of decline possible. Keeping them from accelerating is the goal."
"The heart of the ABC Medical Home model is collaborative care,” said Michael LaMantia, MD, the chief author of the study. LaMantia, is a former Regenstrief Institute and IU Center for Aging Research investigator who recently who is now Section Head of Geriatric Medicine and associate professor of medicine at the University of Vermont College of Medicine.
The ABC Medical Home program is centered at Eskenazi Health, an academic, urban, public hospital, at 10 community health centers located in Indianapolis, and in the homes of patients who receive medical care at these facilities.