The high prevalence of depression in geriatric home healthcare patients poses a challenge to
patients outcomes and high quality care. Depressed patients are less adherent to other
treatment regimens, experience more adverse advents, and have poorer outcomes (Byers et
al., 2008; Friedman et al., 2009; Katon et al., 2010; Sheeran et al., 2004; Sheeran et al.,
2010). High levels of depressive symptoms are clinically significant whether or not a patient
has received a formal depression diagnosis or is already taking antidepressant medication.
Like other chronic medical conditions, depressed home healthcare patients will benefit from
good depression care management.
The Depression CARE for PATients at Home (Depression CAREPATH) intervention was
designed in collaboration with HHA clinicians and administrators for use in home healthcare
in managing depression as part of ongoing care for medical and surgical patients. The
intervention includes both a depression care management protocol designed for use during
regular home visits as well as implementation tools for HHAs.
Our group has demonstrated the feasibility of using the DCM protocol as part of routine care
and of integrating it into six commercial software programs. Based on the feedback from
these agencies and preliminary data, we are conducting an NIH-funded randomized trial to
test the effectiveness of the Depression CAREPATH in seven agencies, located in different
regions of the country. In addition, resources are being developed so that the tools needed to
implement and support Cornell's Depression CAREPATH intervention will be freely and
openly available to HHAs seeking to use the tools.