Project: Research project

Project Details


Depression in primary care is common, morbid, and treatable. Yet
depression in elderly patients frequently goes untreated, and these
patients consume more health care resources than similar patients without
depression. The reasons why geriatric depression goes untreated in
primary care remain unclear, although physician factors including
knowledge and attitudes, patient factors, and the practice environment
have all been implicated as contributing factors. The goal of the proposed research is to determine how physicians,
patients and the practice environment interact to affect the diagnosis,
treatment , and outcomes of geriatric depression in patients known to
have symptoms of depression. We propose to link data on physician
decision-making and prognosticating for individual patients with
patients' clinical characteristics, outcomes, and use of health services
to better understand why individual patients are chosen for treatment and
which patients respond to treatment. We also propose to perform a
long-term follow-up study on a panel of elderly patients to determine the
stability of depressive symptoms over time, and how these symptoms
contribute to patients' health services use and outcome. These studies
will further our understanding of why primary care physicians apparently
undertreat depression, how physicians determine who would benefit from
treatment for depression, and how these practice patterns might be
altered to improve outcomes for depressed elderly patients. The clinical component of this proposal involves the continuation of
ongoing patient care responsibilities in general internal medicine
including longitudinal primary and inpatient care, and focused patient
care opportunities in geriatric primary and long-term care. The teaching
component includes supervision of residents and medical students in the
ambulatory and acute care settings, and didactic sessions in geriatric
assessment, delirium, and dementia. The primary teaching goal of this
proposal is the development of a workshop in outpatient geriatric
assessment for medical residents. The goal of this workshop is to help
resident physicians learn to routinely and efficiently incorporate
geriatric assessment into their general medicine ambulatory care
Effective start/end date7/1/936/30/99


  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health: $80,314.00
  • National Institutes of Health
  • National Institutes of Health


  • Medicine(all)

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