A three-component model for reengineering systems for the treatment of depression in primary care.


Journal Article

Depression in primary care is a chronic disease. As with most chronic diseases, long-term adherence to treatment plans is problematic. Evidence-based systems of care address this problem, but persistence and dissemination of systems after testing is a new problem. The three-component model for the care of patients with depression is a system of widely applicable, easily transported strategies and materials to address dissemination. The three-component model provides a series of routines (processes for structured diagnostic and follow-up-care with a time line) and division of responsibility, including a role for a telephone care manager. In the three-component model, clinician and office education create a prepared practice that is predisposed to providing evidence-based depression management. Enabling elements include the telephone care managers, who are trained to promote adherence to a management plan, and a supervising psychiatrist. The key reinforcing element is care manager reports about patient response to treatment. The three-component model is bound together by a common depression diagnostic and severity measure that facilitates communication and treatment decisions.

Full Text

Duke Authors

Cited Authors

  • Oxman, TE; Dietrich, AJ; Williams, JW; Kroenke, K

Published Date

  • November 2002

Published In

Volume / Issue

  • 43 / 6

Start / End Page

  • 441 - 450

PubMed ID

  • 12444226

Pubmed Central ID

  • 12444226

International Standard Serial Number (ISSN)

  • 0033-3182


  • eng

Conference Location

  • England