Models of care for late-life depression of the medically ill: examples from chronic obstructive pulmonary disease and stroke. Academic Article uri icon

Overview

MeSH

  • Acute Disease
  • Aged
  • Chronic Disease
  • Combined Modality Therapy
  • Disease Management
  • Feasibility Studies
  • Female
  • Humans
  • Late Onset Disorders
  • Male
  • Patient Care Management

MeSH Major

  • Antidepressive Agents
  • Depressive Disorder
  • Pulmonary Disease, Chronic Obstructive
  • Socioenvironmental Therapy
  • Stroke

abstract

  • Depression worsens most treatment outcomes in medically ill older adults. Chronic medical illnesses weaken and demoralize patients and compromise their ability to adhere to treatments requiring consistency and effort. Acute medical illnesses create a psychosocial storm that finds patients and their ecosystem unprepared. We describe two intervention models that can be used to target and personalize treatment in depressed, chronically, or acutely medically ill older adults. The Personalized Adherence Intervention for Depression and COPD (PID-C) is a model intervention for depressed patients with chronic medical illnesses. It targets patient-specific barriers to treatment engagement and aims to shift the balance in favor of treatment participation. PID-C led to higher remission rates of depression, reduction in depressive symptoms, and reduction in dyspnea-related disability. The addition of problem-solving training enables patients to use resources available to them and hopefully improve their outcomes. Ecosystem-focused therapy (EFT) is a model intervention for depression developing in the context of an acute medical event. It was developed for patients with poststroke depression (PSD) and targets five areas, part of the "psychosocial storm" originating from the patient's sudden disability and the resulting change in the patient's needs and family's life. A preliminary study suggests that EFT is feasible and efficacious in reducing depressive symptoms and signs and disability in PSD. Copyright © 2015 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

publication date

  • May 2015

has subject area

  • Acute Disease
  • Aged
  • Antidepressive Agents
  • Chronic Disease
  • Combined Modality Therapy
  • Depressive Disorder
  • Disease Management
  • Feasibility Studies
  • Female
  • Humans
  • Late Onset Disorders
  • Male
  • Patient Care Management
  • Pulmonary Disease, Chronic Obstructive
  • Socioenvironmental Therapy
  • Stroke

Research

keywords

  • Journal Article

Identity

Language

  • eng

PubMed Central ID

  • PMC4272675

Digital Object Identifier (DOI)

  • 10.1016/j.jagp.2014.06.004

PubMed ID

  • 25028344

Additional Document Info

start page

  • 477

end page

  • 487

volume

  • 23

number

  • 5