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Depression is common in primary care but is suboptimally managed. Collaborative care has emerged as a potentially effective candidate intervention to improve the quality of care and patient outcomes for depression. In this issue, Gilbody et al review randomized evidence from 37 studies involving 12 355 people with depression. They found unequivocal evidence of benefit of collaborative care over usual primary care at 6 months and a persistent benefit at up to 5 years. By applying cumulative meta-analysis, they found that sufficient randomized evidence had emerged by the year 2000 to demonstrate significant benefit. This method of organizing care was initially developed and studied within the United States, and further trials in the United States are probably no longer justified. Further research should focus on the implementation of this method of care and in demonstrating its effectiveness in non-US settings.
In This Issue of Archives of Internal Medicine. Arch Intern Med. 2006;166(21):2303. doi:10.1001/archinte.166.21.2303
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