• Carolyn A Chew-Graham, Karina Lovell, Chris Roberts, Robert Baldwin, Michael Morley, Alistair Burns, David Richards, and Heather Burroughs.
• Primary Care Research Group, School of Community Based Medicine, University of Manchester.
• Br J Gen Pract. 2007 May 1; 57 (538): 364370364-70.

BackgroundDepression is the most common mental health disorder in people aged over 65 years. Late-life depression is associated with chronic illness and disability.AimTo investigate the feasibility of a collaborative care model for depression in older people in a primary care setting.Design Of StudyRandomised controlled trial with 16-weeks follow up.SettingA primary care trust in Manchester.MethodParticipants were 105 people aged 60 years or older who scored 5 or more on the Geriatric Depression Scale; 53 were randomly allocated to an intervention group and 52 to a usual care group. The intervention group received care managed by a community psychiatric nurse who delivered an intervention comprising a facilitated self-help programme with close liaison with primary care professionals and old-age psychiatry according to a defined protocol. The usual care group received usual GP care. A nested qualitative study explored the views of the health professionals and patients regarding the acceptability and effectiveness of the intervention.ResultsThe main outcome measure was recovery from depression. Patients in the intervention group were less likely to suffer from major depressive disorder at follow up compared with usual care (0.32, 95% confidence = interval = 0.11 to 0.93, P = 0.036). The qualitative component of the study demonstrated the acceptability of the intervention to patients.ConclusionA model of collaborative care for older people with depression, used in a primary care setting with a facilitated self-help intervention is more effective than usual GP care. This study demonstrates that the implementation of a collaborative care model is feasible in UK primary care and that the intervention is effective and acceptable to patients.

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