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June 16, 2004

Interventions for Treatment of Depression in Primary Care—Reply

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2004;291(23):2814. doi:10.1001/jama.291.23.2815-b

In Reply: Dr Coyne suggests that free medication and psychotherapy compromised the value of our intervention. In fact, our intervention addressed numerous barriers to adequate treatment, including both physician factors (eg, knowledge, competing demands) and patient factors (eg, denial, stigma, adverse effects). We also demonstrated the acceptability and effectiveness of using care managers to promote evidence-based treatment for in primary care. A next step is to increase patients' access to such care by reducing barriers affecting providers (eg, reimbursement) and practices (eg, organization, space).

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