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The Milbank Quarterly logoLink to The Milbank Quarterly
. 1999 Jun;77(2):225–256. doi: 10.1111/1468-0009.00132

Treating Depressed Older Adults in Primary Care: Narrowing the Gap between Efficacy and Effectiveness

Jürgen Unützer 1, Wayne Katon 1, Mark Sullivan 1, Jeanne Miranda 1
PMCID: PMC2751121  PMID: 10392163

Abstract

There is a gap between the efficacy of treatments for late-life depression under research conditions and the effectiveness of treatments as they occur in the “real world” of primary care. Considerable evidence supports the efficacy of treatments for late-life depression, but many depressed older adults either are not recognized or do not receive effective treatment for depression in primary care. Older adults face a range of special treatment barriers: knowledge deficits; losses and social isolation; multiple medical problems; and lack of financial resources. More research is needed to understand these barriers and to study the effectiveness of multifaceted, population-based disease management interventions for late-life depression in primary care.

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