Time to Remission for Depression with Collaborative Care Management (CCM) in Primary Care

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Figure 1.
Time to remission (9-item Patient Health Questionnaire score <5) with collaborative care management versus usual care
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Figure 2.
Persistent depressive symptoms (9-item Patient Health Questionnaire score ≥5) with collaborative care management versus usual care

Table 1. Baseline Demographic Characteristics

	All (n = 7349)	CCM (n = 3595)	UC (n = 3754)	P Value^*
Age (years), mean (SD)	41.8 (16.5)	41.1 (15.7)	42.5 (17.2)	.0080
Female sex, n (%)	5169 (70.4)	2620 (73.1)	2549 (67.9)	<.0001
Marital status (married) , n (%)	3767 (51.3)	1890 (52.7)	1877 (50.0)	.023
Race (white) , n (%)	6721 (91.6)	3347 (93.3)	3374 (89.9)	<.0001
Clinical site, n (%)				<.0001
A	3547 (48.3)	1164 (32.5)	2383 (63.5)
B	950 (12.9)	464 (12.9)	486 (13.0)
C	1503 (20.5)	954 (26.5)	549 (14.6)
D	1340 (18.3)	1004 (28.0)	336 (9.0)
Diagnosis code, n (%)				<.0001
296.2x	3729 (50.8)	1866 (52.0)	1863 (49.6)
296.3x	2596 (35.4)	1427 (39.8)	1169 (31.1)
300.4	1015 (13.8)	293 (8.2)	722 (19.2)
Initial PHQ-9 score, mean (SD)	15.4 (4.1)	15.6 (4.1)	15.1 (4.1)	<.0001
Moderate, n (%)	3564 (48.6)	1633 (45.5)	1931 (51.4)
Moderately severe, n (%)	2485 (33.9)	1287 (35.9)	1198 (31.9)
Severe, n (%)	1291 (17.6)	666 (18.6)	625 (16.6)

↵* Calculated using the χ² test for categorical variables and Wilcoxon rank sum test for ordinal variables.
CCM, collaborative care management; PHQ-9, 9-item Patient Health Questionnaire; SD, standard deviation; UC, usual care.

Table 2. Cox Proportional Hazard Model for Remission of Depressive Symptoms

	Hazard Ratio for Remission^* (95% CI)	P Value
Group
UC	Reference
CCM	2.48 (2.31–2.65)	<.0001
Age (years)
18–50	Reference
51–64	1.00 (0.93–1.08)	.979
65–79	1.43 (1.27–1.60)	<.0001
≥80	1.29 (1.06–1.58)	.012
Sex		.81
Female	Reference
Male	1.01 (0.94–1.08)
Marital status		<.0001
Not married	Reference
Married	1.18 (1.11–1.26)
Race		.113
White	Reference
Nonwhite	0.91 (0.80–1.02)
Clinic
A	Reference
B	1.03 (0.93–1.14)	.563
C	1.34 (1.24–1.45)	<.0001
D	1.27 (1.17–1.38)	<.0001
Diagnosis
Initial	Reference
Recurrent	0.87 (0.82–0.93)	<.0001
Dysthymia	0.98 (0.89–1.08)	.681
Initial PHQ-9 score
Moderate (10–14)	Reference
Moderately severe (15–19)	0.80 (0.75–0.85)	<.0001
Severe (20–27)	0.71 (0.65–0.77)	<0.0001

↵* Remission is defined as a 9-item Patient Health Questionnaire (PHQ-9) score <5.
CCM, collaborative care management; CI, confidence interval; PHQ-9, 9-item Patient Health Questionnaire; UC, usual care.