Telefonisches Fall-Management: Ist ein Benefit für die Versorgung depressiver Menschen in Deutschland zu erwarten? Systematische Literaturübersicht

Zusammenfassung

Hintergrund: Inwieweit ist Telefonisches Fall-Management (TFM) dazu geeignet, die Versorgung depressiver Menschen in Deutschland zu verbessern?

Methode: Systematische Literaturrecherche in den Datenbanken PubMed, Cochrane Library, ISI Web of Science, PsycINFO und PSYNEXplus.

Ergebnisse: Die Effektivität von TFM wurde bisher in zehn randomisierten kontrollierten Studien untersucht. Diese stammen überwiegend aus den USA. TFM reduziert die depressive Symptomatik stärker als eine Standard-Behandlung und führt zu mehr Zufriedenheit mit der Versorgung. Die Wirkungen von TFM auf die Arzneimittel-Compliance sind widersprüchlich.

Diskussion und Schlussfolgerung: Offen ist, in wie weit die Studienergebnisse zu TFM aus dem amerikanischen Raum auf das Deutsche Gesundheitswesen übertragbar sind, da die Größe des Zusatznutzens, der von TFM erwartet werden kann, unter anderem von der Qualität der vorhandenen regulären Depressionsversorgung abhängt. Aufgrund der vielversprechenden Studienergebnisse ist es trotzdem zu empfehlen, TFM auch in Deutschland als Intervention zur Verbesserung der Depressionstherapie zu erproben.

Abstract

Background: Strategies are needed to effectively improve the management of depression in Germany. Can telephone case management (TCM) be a promising strategy to improve depression care in the German health-care system?

Methods: A systematic literature review in PubMed, Cochrane Library, ISI Web of Science, PsycINFO and PSYNEXplus for randomised controlled trials (RCT) that evaluate TCM was carried out.

Results: Ten RCTs that compared TCM to treatment as usual were found. TCM was more effective in reducing depressive symptoms and in increasing satisfaction with care than treatment as usual. Whether TCM was capable of significantly improving pharmacotherapy compliance remained controversial.

Discussion: The effectiveness of TCM seemed to be related to the health-care system structure in which it was implemented. Most studies on TCM were conducted in US-American Health Maintenance Organizations. Thus, it is unclear to what extent these results can be transferred to the German health system. However, in the light of the promising results of these studies it seems to be worthwhile to test TCM also under conditions of the German health-care system.

Schlüsselwörter

Depression - telefonisches Fall-Management - systematische Literaturrecherche - Versorgungsforschung

Key words

depression - telephone case management - systematic literature review - health services research

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