Home Health & Hospice

Intervention program can curb depression among older home health patients, new study shows

Homecare Insider, November 17, 2014

A routine intervention program may provide relief to older home health patients who suffer from moderate to severe depression, according to a new study published in JAMA Internal Medicine.
 
“Among older home health care patients, depression is highly prevalent, is often inadequately treated, and contributes to hospitalization and other poor outcomes,” researchers wrote in the study’s abstract, citing the consequent necessity of “feasible and effective” interventions to curb the serious illness.
 
For the study, researchers analyzed whether older Medicare home health patients with depression can benefit from a specific intervention program versus enhanced usual care. The trial program, entitled Depression Care for Patients at Home (Depression CAREPATH), trains nurses to both identify and manage depression during routine home visits through weekly symptom assessment, medication management, care coordination, education, and goal setting. It consists of four hours of onsite training and three hours of web education for nurses, plus a telephone call from researchers to intervention team supervisors every other week.
 
Researchers conducted a randomized clinical trial at six home health agencies around the country to test the effectiveness of the intervention. From January 13, 2009 until December 6, 2012, Medicare home health patients 65 years and older who screened positive for depression were recruited and treated with either the CAREPATH intervention or traditional enhanced care. Researchers conducted multiple follow-up interviews about participants’ condition over the course of a year.
 
Of 502 eligible patients, 306 enrolled in the study. Participants were predominantly female (69.6%) and racially and ethnically diverse.
 
Results of the study reveal that CAREPATH was successful at relieving symptoms of depression for patients—within certain limits.
 
“Home health care nurses can effectively integrate depression care management into routine practice. However, the clinical benefit seems to be limited to patients with moderate to severe depression,” researchers concluded.
 
Click here to read the abstract of the study.