Response to depression treatment in the Aging Brain Care Medical Home model

Figures & data

Table 1 Association of PHQ-9 follow-up status with demographics and comorbid conditions

Characteristic	PHQ-9 on additional visits (n=773)	No PHQ-9 on additional visits (n=98)	P-value
Female (%)	79.4	77.6	0.665
Race			0.469
African-American (%)	51.3	58.0
Other (%)	3.2	3.4
White (%)	45.5	38.6
Age			<0.001
65–69 years (%)	37.0	25.5
70–74 years (%)	27.6	18.4
75–79 years (%)	18.2	25.5
80+ years (%)	17.2	30.6
Diabetes (%)	58.2	55.1	0.556
CAD (%)	38.0	38.8	0.887
CHF (%)	31.4	42.9	0.023
Stroke (%)	31.4	35.7	0.392
Cancer (%)	28.6	24.5	0.395
COPD (%)	31.2	32.6	0.767
Depression (%)	82.4	73.5	0.032
Dementia (%)	12.2	23.5	0.002
Renal disease (%)	19.7	20.4	0.862
Arthritis (%)	8.3	3.1	0.071
Mean baseline PHQ-9 (%)	5.5 (5.1)	4.4 (4.8)	0.025

Abbreviations: PHQ-9, patient health questionnaire-9; CAD, coronary artery disease; CHF, congestive heart failure; COPD, chronic obstructive pulmonary disease.

Table 2 Association of baseline PHQ-9 score with demographics and comorbid conditions (N=773)

Characteristic	% PHQ-9 (0–4)	% PHQ-9 (5–9)	% PHQ-9 (≥10)	P-value
Overall (n=773)	51.9	27.8	20.3
Gender				<0.001
Male (n=159)	63.5	26.4	10.1
Female (n=614)	48.9	28.2	23.0
Race				0.045
Black (n=357)	57.4	25.6	16.8
Other (n=22)	31.8	45.4	22.7
White (n=317)	49.5	26.5	24.0
Age				<0.001
65–69 years (n=286)	42.5	28.9	18.3
70–74 years (n=213)	56.4	26.3	10.2
75–79 years (n=141)	66.1	23.7	5.1
80+ years (n=133)	67.0	23.9	6.7
Diabetes				0.766
No (n=323)	51.4	29.1	19.5
Yes (n=450)	52.2	26.9	20.9
CAD				0.915
No (n=479)	52.2	28.0	19.8
Yes (n=294)	51.4	27.6	21.1
CHF				0.100
No (n=530)	54.3	27.0	18.7
Yes (n=243)	46.5	29.6	23.9
Stroke				0.986
No (n=530)	52.1	27.7	20.2
Yes (n=243)	51.4	28.0	20.6
Cancer				0.395
No (n=552)	53.1	26.4	20.5
Yes (n=221)	48.9	31.2	19.9
COPD				0.027
No (n=532)	55.1	25.6	19.4
Yes (n=241)	44.8	32.8	22.4
Depression				<0.001
No (n=136)	71.3	23.5	5.2
Yes (n=637)	47.7	28.7	23.6
Dementia				0.038
No (n=679)	50.4	28.1	21.5
Yes (n=94)	62.8	25.5	11.7
Renal disease				0.336
No (n=621)	51.2	28.8	20.0
Yes (n=152)	54.6	23.7	21.7
Arthritis				0.525
No (n=709)	52.5	27.5	20.2
Yes (n=64)	45.3	32.8	21.9
Antidepressant				<0.001
No (n=228)	64.5	25.4	10.1
Yes (n=552)	45.8	28.9	25.3
Care provider type at initial visit				0.801
CCA (%)	98.2	98.1	96.8
NP (%)	0.8	0.9	1.9
SW (%)	1.0	0.9	1.3
Care provider type at patients’ subsequent visits
CCA (%)	99.7	99.1	98.7	0.329
NP (%)	2.3	4.3	11.2	<0.001
RN (%)	0.3	0.0	0.7	0.486
SW (%)	1.5	2.4	9.9	<0.001

Abbreviations: CCA, care coordinator assistant; NP, nurse practitioner; RN, registered nurse; SW, social worker; PHQ-9, patient health questionnaire-9; CAD, coronary artery disease; CHF, congestive heart failure; COPD, chronic obstructive pulmonary disease.

Table 3 Mixed model results for PHQ-9 change over time

Baseline PHQ-9	Estimate (SE) (Regression (beta) coefficient)	P-value
≥10
Time	2.152 (0.503)	<0.001
Time squared	−0.124 (0.038)	0.001
Any stroke	−1.493 (0.773)	0.055
Female	5.264 (1.891)	0.006
Female × time	−1.513 (0.535)	0.005
Female × time squared	0.100 (0.041)	0.015
5–9
Time	0.210 (0.039)	<0.001
Antidepressants	−1.186 (0.419)	0.005
CHF	1.146 (0.522)	0.029
CHF × time	−0.167 (0.065)	0.010
0–4
Time	−0.034 (0.020)	0.090
CHF	−0.270 (0.308)	0.381
CHF × time	0.120 (0.036)	0.001

Abbreviations: PHQ-9, patient health questionnaire-9; SE, standard error; CHF, congestive heart failure.

Figure 1 Predicted PHQ-9 change* from mixed effects model for baseline PHQ-9 (10+).

Note: *Increase change score = decrease in PHQ-9 (improving symptoms).
Abbreviation: PHQ-9, patient health questionnaire-9.

Figure 2 Predicted PHQ-9 change from mixed effects model for baseline PHQ-9 (5–9).

Abbreviations: PHQ-9, patient health questionnaire-9; CHF, congestive heart failure.

Figure 3 Predicted PHQ-9 change from mixed effects model for baseline PHQ-9 (0–4).

Abbreviations: PHQ-9, patient health questionnaire-9; CHF, congestive heart failure.