Related Experiment Video
Updated: Aug 22, 2026
Individualized rTMS Treatment for Depression using an fMRI-Based Targeting Method
Published on: August 2, 2021
Re-engineering systems for the treatment of depression in primary care: cluster randomised controlled trial
Allen J Dietrich1, Thomas E Oxman, John W Williams
1Dartmouth Medical School, HB 7250, Hanover, NH 03755, USA. allen.j.dietrich@dartmouth.edu
Objective:
To test the effectiveness of an evidence based model for management of depression in primary care with support from quality improvement resources.
Design:
Cluster randomised controlled trial.
Setting:
Five healthcare organisations in the United States and 60 affiliated practices.
Patients:
405 patients, aged > or = 18 years, starting or changing treatment for depression.
Intervention:
Care provided by clinicians, with staff providing telephone support under supervision from a psychiatrist.
Main Outcome Measures:
Severity of depression at three and six months (Hopkins symptom checklist-20): response to treatment (> or = 50% decrease in scores) and remission (score of < 0.5).
Results:
At six months, 60% (106 of 177) of patients in intervention practices had responded to treatment compared with 47% (68 of 146) of patients in usual care practices (P = 0.02). At six months, 37% of intervention patients showed remission compared with 27% for usual care patients (P = 0.014). 90% of intervention patients rated their depression care as good or excellent at six months compared with 75% of usual care patients (P = 0.0003).
Conclusion:
Resources such as quality improvement programmes can be used effectively in primary care to implement evidence based management of depression and improve outcomes for patients with depression.
