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Shulman R, Arora R, Geist R, et al. Integrated Community Collaborative Care for Seniors with Depression/Anxiety and any Physical Illness. Can Geriatr J. 2021;24(3):251-257doi: 10.5770/cgj.24.473.
Shulman, R., Arora, R., Geist, R., Ali, A., Ma, J., Mansfield, E., Martel, S., Sandercock, J., & Versloot, J. (2021). Integrated Community Collaborative Care for Seniors with Depression/Anxiety and any Physical Illness. Canadian geriatrics journal : CGJ, 24(3), 251-257. https://doi.org/10.5770/cgj.24.473
Shulman, Richard, et al. "Integrated Community Collaborative Care for Seniors with Depression/Anxiety and any Physical Illness." Canadian geriatrics journal : CGJ vol. 24,3 (2021): 251-257. doi: https://doi.org/10.5770/cgj.24.473
Shulman R, Arora R, Geist R, Ali A, Ma J, Mansfield E, Martel S, Sandercock J, Versloot J. Integrated Community Collaborative Care for Seniors with Depression/Anxiety and any Physical Illness. Can Geriatr J. 2021 Sep 01;24(3):251-257. doi: 10.5770/cgj.24.473. eCollection 2021 Sep. PMID: 34484507; PMCID: PMC8390319.
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Can Geriatr J. 2021 Sep 01;24(3):251-257. doi: 10.5770/cgj.24.473. eCollection 2021 Sep.

Integrated Community Collaborative Care for Seniors with Depression/Anxiety and any Physical Illness.

Canadian geriatrics journal : CGJ

Richard Shulman, Reenu Arora, Rose Geist, Amna Ali, Julia Ma, Elizabeth Mansfield, Sara Martel, Jane Sandercock, Judith Versloot

Affiliations

  1. Trillium Health Partners, Mississauga, ON, Canada.
  2. Division of Geriatric Psychiatry, Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
  3. Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
  4. Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada.
  5. Faculty of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada.
  6. U Institute of Communication, Culture, Information, & Technology, University of Toronto, Mississauga, ON, Canada.
  7. Institute for Health Policy, Management, & Evaluation, University of Toronto, Toronto, ON, Canada.

PMID: 34484507 PMCID: PMC8390319 DOI: 10.5770/cgj.24.473

Abstract

BACKGROUND: We report on the feasibility and effectiveness of an integrated community collaborative care model in improving the health of seniors with depression/anxiety symptoms and chronic physical illness.

METHODS: This community collaborative care model integrates geriatric medicine and geriatric psychiatry with care managers (CM) providing holistic initial and follow-up assessments, who use standardized rating scales to monitor treatment and provide psychotherapy (ENGAGE). The CM presents cases in a structured case review to a geriatrician and geriatric psychiatrist. Recommendations are communicated by the CM to the patient's primary care provider.

RESULTS: 187 patients were evaluated. The average age was 80 years old. Two-thirds were experiencing moderate-to-severe depression upon entry and this proportion decreased significantly to one-third at completion. Qualitative interviews with patients, family caregivers, team members, and referring physicians indicated that the program was well-received. Patients had on average six visits with the CM without the need to have a face-to-face meeting with a specialist.

CONCLUSION: The evaluation shows that the program is feasible and effective as it was well received by patients and patient outcomes improved. Implementation in fee-for-service publicly funded health-care environments may be limited by the need for dedicated funding.

© 2021 Author(s). Published by the Canadian Geriatrics Society.

Keywords: anxiety; chronic illness; collaborative care; depression; integrated care; mental health; psychotherapy; seniors

Conflict of interest statement

CONFLICT OF INTEREST DISCLOSURES The authors declare that no conflicts of interest exist.

References

  1. Trials. 2012 Aug 20;13:139 - PubMed
  2. Int Psychogeriatr. 2004 Mar;16(1):13-31 - PubMed
  3. BMJ Open. 2013 Jan 24;3(1): - PubMed
  4. J Am Geriatr Soc. 2004 Dec;52(12 Suppl):S249-57 - PubMed
  5. J Affect Disord. 2017 Oct 15;221:192-197 - PubMed
  6. Mol Psychiatry. 2014 Jan;19(1):14-9 - PubMed
  7. J Am Geriatr Soc. 2005 Apr;53(4):695-9 - PubMed
  8. JAMA. 2017 Feb 21;317(7):728-737 - PubMed
  9. Health Qual Life Outcomes. 2010 May 19;8:51 - PubMed
  10. Implement Sci. 2013 Sep 20;8:110 - PubMed
  11. Arch Intern Med. 2006 May 22;166(10):1092-7 - PubMed
  12. Health Aff (Millwood). 2015 May;34(5):727-31 - PubMed
  13. Patient Educ Couns. 2014 Jan;94(1):33-42 - PubMed
  14. Am J Geriatr Psychiatry. 2015 May;23(5):506-13 - PubMed
  15. Can J Psychiatry. 2017 Nov;62(11):761-771 - PubMed
  16. Am J Geriatr Psychiatry. 2016 Apr;24(4):320-6 - PubMed
  17. Am J Psychiatry. 2004 Aug;161(8):1455-62 - PubMed
  18. N Engl J Med. 2013 Feb 7;368(6):493-6 - PubMed
  19. JAMA. 2002 Dec 11;288(22):2836-45 - PubMed
  20. Jt Comm J Qual Patient Saf. 2006 Mar;32(3):167-75 - PubMed
  21. J Gen Intern Med. 2001 Sep;16(9):606-13 - PubMed

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