Impact of Collaborative Care on Depression in Patients Aged 60+: A Secondary Analysis of the GermanIMPACT Study on Behavioural Activation

Depressive disorders are highly prevalent among older adults (60+) in Europe. Activating these patients was a core component of the GermanIMPACT study, which evaluated collaborative care in a cluster-randomized primary care setting. The intervention group showed a significant improvement in PHQ-9 re...

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Main Authors: Sigrid Boczor, Sanaz Ashrafi, Frederike Bjerregaard, Christiane Bleich, Thomas Grochtdreis, Dagmar Lühmann, Martin Härter, Lars Hölzel, Michael Hüll, Iris Tinsel, Martin Scherer, Thomas Kloppe
Format: Article
Language:English
Published: MDPI AG 2025-04-01
Series:Behavioral Sciences
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Online Access:https://www.mdpi.com/2076-328X/15/4/462
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Summary:Depressive disorders are highly prevalent among older adults (60+) in Europe. Activating these patients was a core component of the GermanIMPACT study, which evaluated collaborative care in a cluster-randomized primary care setting. The intervention group showed a significant improvement in PHQ-9 remission. The aim of this secondary analysis was to investigate which activities were planned and whether their implementation or non-implementation was associated with depressive symptoms (PHQ-9) after 12 months. Behavioural activation data were collected by the care managers. A categorization for activity type (collected as free text) and activity implementation status was developed. The association of successfully implemented activities, planned-not-implemented activities, and the number of activities per patient with the 12-month PHQ-9 total score was calculated using logistic regressions (adjusted for age, gender, living situation/baseline PHQ-9). A total 2188 activities were planned for 136 patients; 66% were successfully implemented. Mean age was 71 (±7) years (78% female; 52% living alone). Activities focusing on “self-care/spirituality” improved the PHQ-9 outcome (OR 1.540; <i>p</i> = 0.048), while planned-not-implemented activities overall worsened it (OR 1.16; <i>p</i> = 0.007). Patient activation is key to treating depressive symptoms in old age. Particularly ‘self-care/spirituality’ activities could be planned, and organizational activities should be closely supported.
ISSN:2076-328X