Integrated Care Models for Older Adults with Depression and Physical Comorbidity: A Scoping Review

Laura Tops; Simon Gabriël Beerten; Mathieu Vandenbulcke; Mieke Vermandere; Mieke Deschodt

doi:10.5334/ijic.7576

Figures & Tables

Table 1

Core components of the integrated care models.

CARE MODEL	SERVICE DELIVERY							LEADERSHIP & GOVERNANCE			WORKFORCE			FINANCING		TECHNOLOGY		INFORMATION & RESEARCH
CARE MODEL	PERSON-CENTRED	TAILORED HOLISTIC ASSESSMENT	SELF-MANAGEMENT SUPPORT	PRO-ACTIVE	INFORMAL CAREGIVER INVOLVEMENT	TREATMENT INTERACTION	CONTINUITY	SHARED DECISION-MAKING	INDIVIDUALIZED CARE PLANNING	COORDINATION TAILORED TO COMPLEXITY OF CARE NEEDS	MULTIDISCIPLINARY TEAM	NAMED COORDINATOR	CORE GROUP	OUT OF POCKET COSTS	FINANCIAL INCENTIVES	ELECTRONICAL MEDICAL RECORDS & PATIENT PORTALS	E-HEALTH TOOLS OR TELEMEDICINE	INDIVIDUAL RISK PREDICTION	EFFECTIVE USE OF INDIVIDUAL LEVEL DATA, I.E., AUTOMATIC NOTIFICATION OF ED VISIT	COMPUTERIZED ALGORITHMS THAT RECOMMEND CARE PATHWAYS
BRIGHTEN [50 53]	X	X	X	X		X	X	X	X	X	X	DCM	DCM, PCP, GPsychi, C, Nut, O, Phys, SW, Gpsycho			X	X
CAREPATH [42 54]	X	X	X	X	X	X	X	X	X	X	X	DCM	DCM, PCP			X	X
CASPER plus [43 55 56]	X	X	X	X	X	X	X	X	X	X	X	CM	CM, PCP, MHS		X	X	X	X	X
CEPIS [51]	X	X	X	X		X	X	X	X	X	X	CM	CM [N], GP, MHS			X
DCM China [41 57]	X	X	X	X	X	X	X		X	X		X	CM	CM, PCP, MHS, N			X
GermanIMPACT [45 58]	X	X	X	X		X	X	X	X	X	X	CM	CM, PCP, MHS, P			X
IMPACT [49 59 60 61 62 63 64 65 66 67 68 69 70 71]	X	X	X	X		X	X	X	X	X	X	DCM	DCM, PCP, Psychi, P	X	X	X	X
IMPACT-DP [47]	X	X	X	X		X	X	X	X	X	X	CM	CM [N], PCP, GPsychi			X	X
Improving Depression Treatment for Older Minority Adults in Public Sector Care [46]	X	X	X	X		X	X	X	X	X	X		PCP, Psych, SW	X
Multifaceted shared care intervention for late life depression in residential care [52]	X	X	X	X		X	X	X	X	X	X	PCP	PCP, Residential staff, N, MHS
PRIDE [48]	X	X	X	X		X	X	X	X	X	X	CM	CM [N], PCP, GPsychi			X	X
PROSPECT [40 72 73 74 75 76 77]	X	X		X		X	X	X	X	X	X	DCM	DCM, PCP, GPsychi				X	X
The Seniors Outpatient Community-Based Collaborative Care Model [44]	X	X	X	X	X	X	X		X	X	X	CM	CM, PCP, GPsychi, G,				X

[i] GPsychi: geriatric psychiatrist; GPsycho: geriatric psychologist; PCP: primary care physician; N: nurse; MHS: mental health specialist; Psych: psychotherapist; Psychi: psychiatrist; SW: social worker; P: patient; G: geriatrician; [D]CM: [depression] care manager; C: chaplain; Nut: nutritionist; O: occupational therapist; Phys: physical therapist.

Table 2

Reported clinical and organisational outcomes.

	CLINICAL OUTCOMES																						ORGANISATIONAL OUTCOMES					N
DEPRESSION SYMPTOMS	SEVERITY OF DEPRESSION/REMISSION	DEPRESSION RESPONSE TO TREATMENT	ANXIETY	SUICIDAL IDEATION	FUNCTIONAL STATUS	MENTAL HEALTH	ADLS	IADLS	SF-12	STIGMA	PATIENT SATISFACTION	HEALTH-RELATED QUALITY OF LIFE	PAIN	ANALGETIC USE	ANTIDEPRESSANT MEDICATION USE	HOPELESSNESS	SELF-MANAGEMENT	RESILIENCE	ACTIVITY SCHEDULING	ENGAGEMENT IN ACTIVITIES	VITAL STATUS	THERAPY ATTENDANCE	ED VISITS	GP VISITS	USE OF MENTAL HEALTH SERV	HEALTHCARE COSTS	27
Alexopoulos 2005		+		0	0	+	0									0	+											7
Alexopoulos 2009		+	+		+																							3
Bogner 2005		0	0																									2
Bogner 2007		0			0			0														0						4
Bogner 2012		+			0																							2
Bosanquet 2017		+		+		0	0						0			0			+								0	8
Bruce 2004		+	+		+																							3
Bruce 2015		+				0		0	0																			4
Callahan 2005						+			+	+																		3
Chen 2015	+	+	+							+	+	+																6
Chew-Graham 2007	+	0				0								0														4
Emery 2012	+					0	+																					3
Fann 2009	+	+	+			+						+	+			+										+		8
Harpole 2005		0	0	0			0						0			0												6
Hunkeler 2006	+	+	+			0	+			0		+	+			+		+								0		11
Khambaty 2018		+														0												2
Lin 2006		0				+								+	0					0								5
Lin 2003		+				+							+	+														4
Llewelyn Jones 1999	+					0			0									0						0	0			6
Ng 2020		+	+				0					+	+															5
Penkunas 2015		+																					+					2
Riebe 2012		+																		+	+							3
Schulberg 2007		0			0																							2
Shulman 2021		+		+		0																						3
Thielke 2007		0												0														2
Unutzer 2002	+	+	+			+						+				0											0	7
Unutzer 2008		+				+						+		+				+		+								6
Van LeeuwenWilliams 2009	0	0	0	0	0	0	0							0												0		9
Williams 2004		+				+										0		0										4
N	8	26	10	5	7	16	7	2	3	3	1	6	6	6	1	8	1	4	1	3	1	1	1	1	1	3	2

[i] 0 = non-significant; + = significant.

Integrated Care Models for Older Adults with Depression and Physical Comorbidity: A Scoping Review

Figures & Tables

Table 1

Table 2

Figure 1

Paradigm

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