Identification and treatment of depression of older adults in primary care: findings from the São Paulo Ageing and Health Study.
Identification and treatment of depression of older adults in primary care: findings from the São Paulo Ageing and Health Study.
复制标题
初级保健中老年人抑郁症的识别和治疗：圣保罗老龄化与健康研究的结果。
作者：
M. Scazufca;P. Menezes;K. Tabb;R. Kester;W. Rössler;Hsiang Huang
背景
抑郁症、糖尿病和高血压是造成全球疾病负担的主要因素;然而，大多数关于抑郁症和合并症的研究都来自高收入国家。
目的
本研究通过巴西圣保罗的家庭健康计划（FHP），检查了在初级保健中接受服务的老年人的抑郁症识别率，并比较了抑郁症与糖尿病和高血压的治疗率。
方法
共有1558名圣保罗老龄化和健康研究参与者（居住在圣保罗的65岁以上低收入成年人）在FHP中登记，并纳入分析。对具有国际疾病分类第10版（ICD-10）抑郁症诊断（来自调查访谈）的参与者进行图表审查，以验证这些人是否记录了抑郁症。抑郁症、糖尿病和高血压的治疗根据临床评估和药物检查进行评估。
结果
73名参与者（4.8%）患有ICD-10抑郁症，344名（23.2%）确诊为糖尿病，1207名（79.3%）确诊为高血压。通过医疗图表审查确定患有抑郁症的比例（可以找到图表的个人n = 63）为4.8%（n = 3）。9名（12.3%）ICD-10抑郁症患者接受了治疗。糖尿病和高血压的治疗率分别为72.4%和77.4%。
结论
与糖尿病和高血压的治疗率相比，在家庭保健中心接受治疗的老年人的抑郁症治疗水平非常低。需要在FHP中进行治疗抑郁症的协作护理有效性试验，以提高该人群的抑郁症护理质量。
BACKGROUND
Depression, diabetes and hypertension are major contributors to the global burden of disease; however, the majority of research on depression and co-morbid conditions originates in high-income countries.
OBJECTIVE
This study examines the depression identification rate and compares treatment rates of depression with those of diabetes and hypertension among elderly individuals served in primary care through the Family Health Program (FHP) in São Paulo, Brazil.
METHOD
A total of 1558 São Paulo Ageing and Health Study participants (low-income adults ≥65 years old living in São Paulo) registered in the FHP were included for analysis. Chart review was performed for participants with an International Classification of Diseases, 10th edition (ICD-10) depression diagnosis (from survey interview) to verify if depression was recorded for these individuals. Depression, diabetes and hypertension treatment were assessed based on clinical assessments and medication checks.
RESULTS
Seventy-three participants (4.8%) had ICD-10 depression, 344 (23.2%) had confirmed diabetes and 1207 (79.3%) had confirmed hypertension. The proportion of those identified with depression by medical chart review (n = 63 for individuals whose chart could be found) was 4.8% (n = 3). Nine individuals (12.3%) with ICD-10 depression were treated. Rates of diabetes and hypertension treatment were 72.4% and 77.4%, respectively.
CONCLUSION
Levels of treatment of depression in older adults receiving care in the FHP is very low compared to treatment rates of diabetes and hypertension. Collaborative care effectiveness trials for the treatment of depression in the FHP are needed to improve the quality of depression care for this population.
影响因子：
5.1
作者：
Mendenhall, Emily;Norris, Shane A.;Shidhaye, Rahul;Prabhakaran, Dorairaj
通讯作者：
Prabhakaran, Dorairaj
DOI：
10.1056/nejmoa1003955
发表时间：
2010-12-30
期刊：
The New England journal of medicine
影响因子：
--
作者：
Katon WJ;Lin EH;Von Korff M;Ciechanowski P;Ludman EJ;Young B;Peterson D;Rutter CM;McGregor M;McCulloch D
通讯作者：
McCulloch D