Effectiveness of the Program to Encourage Active, Rewarding Lives (PEARLS) to reduce depression: a multi-state...

Area of Science:

• Gerontology
• Public Health
• Psychiatry

Background:

• Late-life depression affects an estimated 15% of community-dwelling older adults in the U.S.
• The Program to Encourage Active, Rewarding Lives (PEARLS) is an evidence-based, collaborative care model designed to manage depression in older adults.
• PEARLS is delivered by community-based organizations to enhance access to quality depression care.

Purpose of the Study:

• To assess the effectiveness of the PEARLS program in reducing depressive symptoms among older adults.
• To evaluate clinical outcomes including depression severity, remission, and response using the PHQ-9 instrument.
• To analyze changes in depressive symptoms from baseline to the final session in a real-world setting.

Main Methods:

• Utilized data from 1,155 PEARLS participants across four states between 2015-2021.
• Employed a generalized estimating equation (GEE) model to examine changes in PHQ-9 scores, adjusting for demographic and clinical covariates.
• Used Cox proportional hazards regression to estimate the hazard ratio for clinical remission or response.

Main Results:

• PHQ-9 scores significantly improved from baseline to final sessions (mean difference = -5.67, p < 0.001).
• Approximately 35% of participants achieved clinical remission (PHQ-9 < 5), and 73% achieved remission based on cardinal symptoms.
• Nearly 49% of participants demonstrated a clinical response (≥ 50% decrease in PHQ-9 scores).

Conclusions:

• The PEARLS program is effective in improving depressive symptoms in older adults within community settings.
• PEARLS offers an accessible option for older adults with depression, particularly those underserved by traditional clinical care.
• The findings support PEARLS as a valuable intervention for managing late-life depression in diverse populations.