Table 11Functional and quality of life outcomes

Outcome
Project or Author
MeasurementPatient CategoryAssessment PeriodDirection of EffectResultsComment
DEPRESSION
Functioning/Disability
IMPACT 2, 121, 130 SF12 overall functional impairment 3 monthsIntervention-0.67, 95% CI -0.9; -0.4, p<.001
6 monthsIntervention-0.35, 95% CI -0.6; -0.5, p<.02
12 monthsIntervention-1.03, 95% CI -1.31; -0.74, p<.0001
18 monthsIntervention-0.47, 95% CI -0.74; -0.19, p=.0009
24 months NS
IADLs 3 months NS
6 months NS
12 months-1.5, 95% CI -0.29; -0.01, p=.04
QuEST 5, 181 Patient work productivity (self-rated)All patients2 yearsInterventionP<.05Estimated value of $1491 per depressed FTE
Consistently employed patients2 yearsInterventionP=.02Estimated value of $1982 per depressed FTE
Inconsistently employed patients2 years NS
Patient absenteeismAll patients2 years NSTrending for intervention at P<.06. Absenteeism reduced by 10.6 days over 2 years, value of $539 per depressed FTE
Consistently employed patients2 years NSTrending for intervention at p<.08. Absenteeism reduced by 12.3 days over 2 years, value of $619 per depressed FTE
Inconsistently employed patients2 years NS
SF36 Emotional role functioning 2 yearsInterventionP=.002Treatment × time
SF36 Physical role functioning2 yearsInterventionP=.005Treatment × time
Finley, 2003 108 Work and social disability scale6 monthsNS
Partners in Care 122 SF12 Role limitationsQI-meds6 monthsInterventionP<.05
12 monthsInterventionP<.05
18 months NS
24 months NS
QI-therapy6 monthsIntervention, usual care and QI-medsP<.05
12 monthsIntervention, usual care and QI-medsP<.05
18 monthsInterventionP<.05
24 monthsNS
Hedrick, 2003 87 Sheehan disability scale 3 monthsIntervention-0.53, 95% CI -1.04; -0.02, p<.05
9 monthsNS
Katon, 1999 3, 182 Sheehan disability scaleAll patients1 month NS
3 monthsInterventionP=.05
6 months NS
28 monthsInterventionP=.04Treatment × time
Moderate severity28 months NS
High severity28 months NS
SF36 social functioning 6 months NS
SF36 role functioning6 monthsNS
Physical Quality of Life
Fortney, 2006 92 SF12V PCS 6 monthsNo differenceNS
12 monthsNo differenceNS
IMPACT 2, 130 SF12 general health 12 monthsIntervention-0.32, 95% CI -0.42;
-0.22, p<.0001
18 monthsIntervention-0.19, 95% CI -0.42;
-0.22, p=.0002
24 monthsIntervention-0.17, 95% CI -0.27;
-0.06, p=.0015
SF12 PCS 3 monthsIntervention1.08, 95% CI 0.36; 1.80, p=.003Secondary analysis showed difference in functional status at 1 year accrued to those patients who showed improvement in depression symptoms.
6 monthsIntervention1.57, 95% CI 0.78; 2.34, p<.001
12 monthsIntervention1.71, 95% CI 0.96; 2.47, p<.0001
18 monthsIntervention1.14, 95% CI 0.34; 1.93, p=.0050
24 monthsIntervention0.83, 95% CI 0.01; 1.64, p=.0481
Clarke, 2005 83 SF12 PCS12 monthsNS
Partners in Care 122, 123 SF12 PCSAll interventions6 months NS
12 months NS
QI-meds6 months NS
12 months NS
18 months NS
24 months NS
QI-therapy6 months NS
12 months NS
18 months NS
24 monthsNS
Hedrick, 2003 87 SF36 PCS 3 months NS
9 monthsNS
Boudreau, 2002 175 SF12 PCS12 monthsNS
Mental Quality of Life
Fortney, 2006 92 SF12V MCS 6 months NS
12 monthsInterventionEffect size 0.46
PRISM-E 118 SF36 MCSMajor depression3 month
6 month NS
Other depression3 month
6 month NS
All depression3 month
6 monthNS
Clarke, 2005 83 SF12 MCS12 monthsEffect size 0.203
Partners in Care 122, 123 SF12 MCSAll interventions6 monthsAll interventionsP=.009
12 monthsAll interventionsP=.04
QI-meds6 months NS
12 months NS
18 months NS
24 months NS
5 years NS
QI-therapy6 monthsInterventionP<.05
12 monthsInterventionP<.05
18 monthsInterventionP<.05
24 monthsInterventionP<.05
5 yearsNS
Hedrick, 2003 87 SF36 MCS 3 months NS
9 monthsNS
Boudreau, 2002 175 SF12 MCS12 monthsNS
Hunkeler, 2000 110 (reporting telehealth nurse only, not peer support)SF12 MCS 6 weeksInterventionP=.004
6 monthsNS
Asarnow, 2005 114 SF12 MCS6 monthsIntervention2.6, 95% CI 0.3, 4.8, p=.03
Wellbeing
Fortney, 2006 92 Change in Quality of Well Being score 6 monthsInterventionEffect size 1.43
12 monthsNS
IMPACT 121 SF12 overall quality of life in past month 3 monthsIntervention0.49, 95% CI 0.27; 0.69, p<.001
6 monthsIntervention0.41, 95% CI 0.17; 0.63, p<.001
12 monthsIntervention0.56, 95% CI 0.32; 0.79, p<.001
Patient Self-efficacy
IMPACT 2 Confidence managing depression 12 monthsIntervention0.77, 95% CI 0.55; 0.99, p<.0001
24 monthsIntervention0.39, 95% CI 0.16; 0.62, p=.001
ANXIETY DISORDERS
Functioning/Disability
Roy-Byrne, 2001 109 SF36 Role functioning 12 monthsInterventionP=.03
SF36 Social functioning12 months NS
CCAP 9 WHO disability scale 3 monthsInterventionEffect size 0.29
6 monthsInterventionEffect size 0.31
9 monthsInterventionEffect size 0.33
12 monthsInterventionEffect size 0.34
EMPLOYMENT STATUS
Physical Quality of Life
CCAP 9 SF12 PCS 3 months NS
6 months NS
9 months NS
12 monthsNS
Rollman, 2005 101 SF12 PCSAll patients12 monthsNS
Mental Quality of Life
CCAP 9 SF12 MCS 3 monthsInterventionEffect size 0.33
6 monthsInterventionEffect size 0.27
9 months NS
12 monthsNS
Rollman, 2005 101 SF12 MCSAll patients12 monthsIntervention0.39, 95% CI 0.10; 0.68, p=.03Intervention × time
Panic disorder12 monthsIntervention0.50, 95% CI 0.11; 0.89, p=.004Intervention × time
General anxiety disorder12 monthsNS
OTHER DISORDERS
Mental Quality of Life
PRISM-E 126 SF-12 MCS6 monthsNS

From: 3, Results

Cover of Integration of Mental Health/Substance Abuse and Primary Care
Integration of Mental Health/Substance Abuse and Primary Care.
Evidence Reports/Technology Assessments, No. 173.
Butler M, Kane RL, McAlpine D, et al.

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