Publications by authors named "Jay Otero"

Objective: Care management is feasible to deploy in routine care, and the depression outcomes of patients reached by this evidence-based practice are similar to those observed in randomized controlled trials. However, no studies have estimated the population level effectiveness of care management when deployed in routine care. Population level effectiveness depends on both reach into the target population and the clinical effectiveness for those reached.

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Background: Collaborative-care management is an evidence-based practice for improving depression outcomes in primary care. The Department of Veterans Affairs (VA) has mandated the implementation of collaborative-care management in its satellite clinics, known as Community Based Outpatient Clinics (CBOCs). However, the organizational characteristics of CBOCs present added challenges to implementation.

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Numerous studies have demonstrated that collaborative care (care management) for depression improves outcomes, yet few clinics have implemented this evidence-based practice. To promote adoption of this best practice, our objective was to describe the steps needed to tailor collaborative care models for local needs, resources, and priorities while maintaining fidelity to the evidence base. Based on lessons learned from 2 multisite Veterans Affairs implementation studies conducted in 2 different clinical, organizational, and geographic contexts, we describe in detail the steps needed to adapt an evidence-based collaborative care program for depression for local context while maintaining highly fidelity to the research evidence.

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