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Telephone Psychotherapy and Care Management for Depression—Reply
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In Reply: We agree with Dr Tanvetyanon that low rates of follow-up during antidepressant treatment are troublesome. Unfortunately, they are not at all unusual. National Committee for Quality Assurance/Health Plan Employer Data and Information Set standards for adequate follow-up care require at least 3 visits over 90 days, but most large health systems meet this standard less than 25% of the time.1 Follow-up care in the clinics participating in our study is actually somewhat better than average.2 We certainly do not condone this unfortunate situation. In fact, we have spent the last 15 years in a program of research and advocacy to improve follow-up care for depression.3-5
A direct comparison with in-person therapy sessions, as suggested by Dr Tanvetyanon, would probably show that they have greater clinical effect than telephone sessions. The advantage of telephone sessions is that they actually occur. Many patients referred for psychotherapy never appear, and fewer . . . [Full Text of this Article]
Gregory Simon, MD
simon.g@ghc.org
Evette Ludman, PhD;
Steve Tutty, MA;
Belinda Operskalski, MPH;
Michael Von Korff, ScD
Center for Health Studies
Group Health Cooperative
Seattle, Wash
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