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April 7, 2010

Collaborative Care for Post-CABG Depression—Reply

JAMA. 2010;303(13):1252-1253. doi:10.1001/jama.2010.363

In Reply: In response to Dr Schrader and colleagues, the generalizability of our findings is indeed limited to patients with depression following coronary artery bypass graft surgery. Nevertheless, stepped collaborative care models have been proven effective at reducing depressive symptoms in dozens of clinical trials conducted in primary care settings1 and successfully applied to the treatment of patients with other cardiac conditions.2 Therefore, we believe that programs similar to ours could be applied to treat depression among patients with a broad range of cardiac conditions. The precise component or components of collaborative care that most contribute to its effectiveness are less crucial to identify as they may vary among patients with differing illness patterns. Moreover, multiple large-scale clinical trials would be needed to determine whether the model's components could work in isolation.

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