Practices randomized to usual care received educational sessions
for primary care physicians and notification of the depression
status of patients. Physicians received no specific
recommendations regarding individual patients (except for
psychiatric emergencies). Practices randomized to the
intervention condition received educational sessionsfor primary
care physicians, education of patients’ families, and a depression
care manager who worked within the practice. The care manager
worked with the primary care physician to recommend treatment
according to standard guidelines. Care managers had psychiatric
back-up including on-demand consultation, weekly supervision
by psychiatrist investigators, and monthly interpersonal therapy
cross site supervision. The 15 care managers included social
workers, nurses, and psychologists who interacted with patients
in person or by telephone at scheduled intervals and as
necessary. Care managers monitored symptoms, adverse effects
of drugs, and adherence to treatment.