The 130th Annual Meeting of APHA

4035.0: Tuesday, November 12, 2002 - 8:30 AM

Abstract #46353

Conducting a geriatric depression treatment trial in home health care

Kathleen Ell, DSW1, Jurgen Unutzer, MD, MPH2, Susan M. Enguidanos, MPH3, and Maria Aranda, PhD1. (1) School of Social Work, University of Southern California, MRF Building - MC0411, Los Angeles, CA 90089-0411, (213) 740-0298, ell@usc.edu, (2) Center for Health Services Research, UCLA Neuropsychiatric Institute, 10920 Wilshire Blvd, Suite 300, Los Angeles, CA 90024, (3) School of Social Work, University of Southern California and Partners In Care Foundation, 101 S. First Street, Suite 1000, Burbank, CA 91502

Few studies have examined the prevalence of geriatric depression among older home health care patients and little is known about providing depression treatments in a geriatric population with acute or serious medical illness and significant functional impairment. This preliminary report is from an ongoing randomized clinical trial of a depression care management program for late life depression that includes the use of antidepressant medications or Problem Solving Treatment (PST) in home health care patients. Results from a 3-month study of the admitting visit screening process in a large home health care agency found that of 344 older home health care patients screened with the PHQ-9 depression rating scale, 19% met criteria for minor/major depression or dysthymia. Preliminary analyses of the randomized trial indicate that a depression screen was completed in 915 (87 %) of 1,052 newly admitted patients. No screen was done in 13% (n=137) patients due to the inability to answer questions, language barriers, or refusal. Of the 915 screened, 166 (18%) met study criteria. Of these, 18% (30) had severe cognitive impairment and 45% of patients had 3 or more medical conditions. Of 65 patients reassessed for depression within about 10 days of admission, 34% (n=22) no longer met minimal depression symptom criteria. Preliminary results indicate a high rate of depression in the population, but also high rates of spontaneous depression symptom remission post acute hospitalization, high rates of cognitive impairment and medical comorbidity. Practical aspects of providing home-based depression care will be discussed.

Learning Objectives:

Keywords: Depression, Elderly

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: SunPlus Home Health
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Cognitive and Emotional Health among Older Adults

The 130th Annual Meeting of APHA