Depression monitoring and patient behavior in the Clinical Outcomes in MEasurement-Based Treatment (COMET) trial

Psychiatr Serv. 2014 Aug 1;65(8):1058-61. doi: 10.1176/appi.ps.201300326.

Abstract

Objective: In this secondary analysis of results of the Clinical Outcomes in MEasurement-Based Treatment (COMET) trial, patient behaviors that might account for the differences observed in clinical outcomes were examined.

Methods: Patients (N=914) diagnosed as having major depressive disorder participated in telephone interviews either monthly for six months (intervention) or at three and six months (usual care) asking about antidepressant medication-taking, use of psychotherapy or counseling, and participation in depression support groups. Physicians (N=83) in the intervention arm received monthly feedback regarding their patients' depression severity.

Results: A total of 664 (73%) patients completed the month 6 interview. The adjusted odds of current antidepressant use at six months were 85% greater (p=.01) for patients in the intervention (N=380) versus usual care (N=284) arms, according to multivariate regression analyses.

Conclusions: More frequent measurement of depression symptoms was associated with greater medication persistence, which in turn may have mediated clinical improvements.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antidepressive Agents / therapeutic use
  • Assessment of Medication Adherence*
  • Counseling / statistics & numerical data
  • Depressive Disorder, Major / drug therapy
  • Depressive Disorder, Major / therapy*
  • Humans
  • Patient Outcome Assessment*
  • Psychotherapy / statistics & numerical data
  • Self-Help Groups / statistics & numerical data
  • Treatment Outcome*

Substances

  • Antidepressive Agents