Outcomes of Depression and Anxiety in a Virtual Collaborative Care Program: A Quality Improvement Study

Area of Science:

• Behavioral Health
• Digital Health
• Collaborative Care Models

Background:

• Millions face barriers to mental healthcare access annually.
• The Clinically Optimal Access to Collaborative Healthcare (COACH) program, a virtual Collaborative Care Model (CCM), aims to overcome these barriers.
• This study evaluates the COACH program's effectiveness in treating major depressive disorder (MDD) and generalized anxiety disorder (GAD).

Purpose of the Study:

• To assess the impact of the COACH program on depression and anxiety symptom severity.
• To determine remission and attrition rates for patients enrolled in the COACH program.
• To evaluate the COACH program as a virtual implementation of the CCM for behavioral health conditions.

Main Methods:

• A retrospective study analyzed data from 531 patients enrolled in the COACH program from November 2021 to October 2024.
• Patient Health Questionnaire-9 (PHQ-9) and GAD-7 scores were collected at baseline, 3, and 6 months.
• Phase analysis of mean monthly scores over 18 months and paired t-tests were used to assess changes.

Main Results:

• By 3 months, 32% with MDD and 40.1% with GAD achieved remission, with an overall attrition rate of 26%.
• Over 18 months, mean monthly PHQ-9 scores decreased from 11.8 to 7.5 (p < 0.001), and GAD-7 scores decreased from 10.8 to 6.4 (p < 0.0001).
• The COACH program demonstrated statistically significant reductions in depression and anxiety symptoms.

Conclusions:

• The COACH program effectively reduces depression and anxiety symptoms, achieving significant remission rates.
• The program demonstrates good patient engagement and offers a viable virtual alternative to traditional care delivery for anxiety and depression.
• This virtual CCM iteration shows promise for improving behavioral health outcomes.