Treating depressed older adults in primary care: narrowing the gap between efficacy and effectiveness

Milbank Q. 1999;77(2):225-56, 174. doi: 10.1111/1468-0009.00132.


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.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Aged
  • Delivery of Health Care
  • Depression / epidemiology
  • Depression / therapy*
  • Depressive Disorder / epidemiology
  • Depressive Disorder / therapy*
  • Female
  • Health Services Accessibility
  • Health Services for the Aged*
  • Humans
  • Male
  • Primary Health Care*
  • Treatment Outcome
  • United States