Page:8
KWMPA Newsletter
The Kondhwa-Wanowrie Medical Practitioners’ Association, Pune.
New Management Committee elected
On the eve of 03rd January 2008, the erstwhile
president of our association, Dr Raj Chavan hosted a
presidential dinner at Shiv-Sagar Restaurant, Wanowrie,
Pune. This was preceded by elections for the new
management committee, conducted by Dr Priya
Rajadhyaksha. After due deliberations, a new committee
was elected under the leadership of Dr Sanjay Salunkhe.
The New Members elected are:
President : Dr Sanjay Salunkhe
Vice president & President elect: Dr Swati Sanghvi
Secretary: Dr Vaishali Parab
Joint Secretary : Dr Subroto Roy
Treasurer: Dr Naveen Raina
Editor : Dr Saurabh Bhatia
Editorial board: Dr Alifia Cementwala; Dr Zohra Siamwala
Immediate past president : Dr Raj Chavan
Members of committee : Drs. V Mandlik, Kunal Kamthe,
Nazima Nazir, Sanjay Bafna, Amul Dighe & Vaishali Chavan
From the President’s desk
Dr Sanjay Salunkhe
With the ushering in of a new team in January 2008,
we found our task cut out for the year. Our first MC meeting
allowed us to determine that the KWMPA had enrolled 161
members till date; While 6 had left Pune for good, the contact
details of 6 others had changed entirely. We presently have
current mailing addresses of 149 members who will get
newsletters by courier henceforth. We will intimate all but 57
members about CMEs/ meetings by email, all but 32 by an
SMS 24 hours before the CMEs; But we are concerned
about 24 members who, if they do not receive the newsletter
have neither an email nor a declared cell phone number.
So for those who cannot physically attend we may organize
a webcast .
For making the above statements possible, let's applaud the
"KWMPA Call Center"(!) V Mandlik, A Cementwala, N
Raina, Kunal Kamthe, Zubbin, Vaishali Parab, Saurabh
Bhatia, Raj Chavan & Nazima; overseen by PP Priya who
was the last one to compile the list three years ago.They
followed-up 15 members each to help create an Excel sheet
(now available on our website kwmpa.co.cc) where all
members' current contact details are available for view.
We request all members to peruse a print copy of this sheet
during the 15 March meeting and make corrections, if any.
Specifically, please update three new columns. Everyone
knows your degree. We now want to know in case you have a
Special niche area in practice (panchakarma, or anterior
segment ophthalmology these are two examples already
on). There is a separate column for Non Medical interests
eg gardening; who knows we may then be able to network &
form common (non medical) interest groups amongst us.
One column will be devoted to Hospital Attachments. I'm
sure you will make that exhaustive; your business interests
will dictate that! .......................Cont’d on page 2
KWMPA Newsletter Copyright KWMPA. For Members only. Not for sale. Sponsored by Ruby Hall Clinic, Pune
Vol:11 Issue:2008-01 Page:1
This newsletter belongs to
-----------------------Stick address labels here---------------------
Upcoming events
"What's New in Medical Oncology_ Targeted Therapy
in Cancer"
Dr Shona Nag, Medical Oncologist, Jehangir Hospital,
Pune.
on Saturday, 15th March, 2008 at 9.30 pm
Venue: The Coronet Elegance, 6th Floor
opp Shivarkar Garden, City International School;
Fatima Nagar, Pune (2681 1500)
CME will be followed by Dinner
KWMPA now has a website
While 2008 paved the way for a new Management
committee, it also ushered in the web era for KWMPA. We
now have a full fledged website. Please pay us a visit at
KWMPA.co.cc
What can you do there:
The website has been made using MOODLE, a
popular learning content management system. This has
allowed us to bring you feature rich content. You must create
your free account by visiting and clicking login. New
members can also join us online. You will be able to send
messages to any other member. The Rules and
Regulations of KWMPA are available online for your ready
reference. We have also uploaded a database of members
with their contact numbers. Not only will this ensure that
other members can access your data freely, it will also be
possible that GOOGLE will show your data to public
searching for relevant doctors.
For learning and knowledge sharing, we have put
a WIKI on the site. It is a collaborative system of document
creation. Anyone can edit and contribute. So if you see a
topic of interest and wish to add something to the info, then
just add it there. Or, may be, start your own topic and share
knowledge. We can put medical quizzes there and on
polls, you may vote for the topics highlighted.
Further, the website has News Forum which allows
you to post any news which automatically gets e-mailed to all
members. There are social forums/discussion boards
where you can start topics close to your heart and discuss
them with others. Or just read around about what others are
discussing. An upcoming event section allows you to
immediately see the details of upcoming CME, picnics etc.
Further, this newsletter will also be available onsite for
online reading. Lastly, you may chat online with other
members who are also online. Since the website is still
experimental, please provide feedback at
s.bhatia@webcyte.biz or call 09881148282.

Family Get Together
On 20th Jan 2008, Dr Raj Chavan, the outgoing
President of our association, and his wife Vaishali, organised
a family get together for the members at Green Valley. The
event was hosted in the green environs of the lawn and had a
DJ playing music right from the beginning. As members
started trickling in, the party picked up the Josh and soon we
had musical chair and dance being organized for children.
Sometime after that, the outgoing committee started
the handing over process of the various charges to the new
committee. The outgoing members were duly felicitated for
their active contribution during the past year.
This was followed by a short initial speech by the
incoming President Dr Sanjay Salunkhe who shared his
vision for activities that he planned in the coming year for the
association members. He went on to formally introduce his
team members. An announcement was made about the
launching of KWMPA website and a lot of members
appeared visibly excited at the prospect of better and prompt
communication.
Following this the President mentioned the Key
Result Areas where he’d lay stress on, in the coming year.
One of the top things on the agenda was to prepare a
comprehensive list of members along with accurate contact
details so that we may promptly communicate with each
other. In the past, this has been seen as a pain point. Dr
Salunkhe created an action team on this and each member
of the committee, including Dr. Priya and Dr. Zubbin were
involved in ensuring the definitive status of each members’
contact details.
The president also announced his continued efforts
in getting sponsorship for the Newsletter from Ruby Hall.
Once the ceremony was over, the Master of the ceremony
paved way for Dance and Dinner. The members could be
seen enjoying both alternately.
The fiesta ended around ten-thirty at night with
everyone appearing to have had an enjoyable weekend that
had charged the batteries for the working week ahead.
Dr S Bhatia (Send feedback on s.bhatia@webcyte.biz)
Advertising rates:
Quarter page (1/4) - Rs. 500/-
Half Page - Rs. 1000/-
Full Page - Rs. 2000/-
Chemists/ doctors and other healthcare related businesses are welcome to advertise
Please contact
Dr Saurabh Bhatia, Editor
Mob: 09881148282
Email: s.bhatia@webcyte.biz
KWMPA Newsletter
Page:2 Page:7
From the president’s desk (cont’d) Eye Surgery
While my friend was working as a receptionist for an eye
The Managing Committee (MC) met twice and the surgeon, a very angry woman stormed up to her desk.
"Someone stole my wig while I was having surgery yesterday,"
minutes of all meetings will soon be available for view on
the website. she complained.
The doctor came out and tried to calm her down. "I assure you
Saurabh's editorial team with Alifia, Zohara &
Zubbin have set deadlines for themselves to see you get the that no one on my staff would have done such a thing," he said.
"Why do you think it was taken here?"
newsletter in time. Vaishali Chavan helped liaison with
Ruby Hall for the sponsorship of the Newsletter. Swati &
Shekhar Sanghvi helped liaison with Coronet Hotel for the "After the operation, I noticed the wig I was wearing was cheap-
looking and ugly."
venue; and lead a core team of Amol Dighe, Nazima, Alifia,
Subroto Roy & Sanjay Bafna to make the first meeting a
success. "I think" explained the surgeon gently, "that means your
cataract operation was a success.”
The names of the MC members (emails, cellphones,
etc.) will be permanently available for view on the website for Get well message
this year. However, the print space devoted for this in
newsletters shall be used to acknowledge contribution of A motorcycle patrolman was rushed to the hospital with an
inflamed appendix. The doctors operated and advised him that
members who actually worked for the association (MC
members or otherwise). all was well. However, the patrolman kept feeling something
pulling at the hairs on his chest. Worried that it might be a
second surgery the doctors hadn't told him about, he finally got
Working & suggesting projects/events for KWMPA enough energy to pull his hospital gown down enough so he
need not be the prerogative of MC members. So feel free to could look at what was making him so uncomfortable.
send me an SMS (9822051735) if you have suggestions &
want to participate in “MC" meetings; I will ensure that you Taped firmly across his hairy chest were three wide strips of
are invited. I think none of us is more "respectable" than the adhesive tape, the kind that doesn't come off easily. Written in
other. large black letters was the sentence.
"Get well quick..... from the nurse whom you fined last week.”
KWMPA will grow rapidly only if each member
wishing to contribute actually gets to do so. Call me Marxist if
you like! but we should be a classless Society. We look
forward to your incessant active participation and co- Young achievers
operation in making your KWMPA better .
This space is for the kids of the members to highlight their talent; write a poem, short story, sketch, or share success stories like academic success,
sports achievements, stage performance etc. Send contributions to Dr Saurabh Bhatia at s.bhatia@webcyte.biz
Please send feedback to Sanjay Salunkhe on
Mobile:98220 51735 Shardul Parab age 10
Email: sanjay.salunkhe@rediffmail.com , years, S/o Mr. Shailendra
Parab and Dr. Vaishali
Parab, was selected as the
"KIDS IDOL", in the age
group 9 to 14 years, for the
year 2007-2008 by
MAHARASHTRA
HERALD.
Sketches:
House sketch
By Lubaina Cementwala,
Age: 9
St. Mary's School, Std. 4.
Shin Chan
By Saaz Bhatia
Age 9
APS, Std-IV
KWMPA Newsletter
 Page 6 Page:3

Breathe Your Weight Out Where health for all is a reality, not a Science and Sensibility: An Interview With
Dr. Alifia Cementwala. dream... Professor Rolf M. Zinkernagel, Nobel
By Dr Amol Dighe Life in Basic Research
A lot of people claim that their hectic schedule leaves
Prize Winner for Medicine 1996
Do you believe that being in big institutions ( such as the
them little time for a regular exercise regimen. For them, In today's life we often end up neglecting our greatest Ivy League institutes) enhances the prospects of one
there is an easier technique involving Deep Breathing gift “our health”. A need for maintaining this gift is therefore
Editor’s comments: I have included this piece not merely winning the Nobel Prize as against, say, being the head
Exercises. Deep breathing offers benefits that might make a the need of time. One such institute which caters to this is the
because of academic merit but also for the pleasure of of a smaller laboratory early in your life?
major difference in health Dr M.L.Dhawale Memorial Trust (MLDT). It is a not-for-profit
reading a Nobel Laureate’s radical comments expressed There is no such standard rule, provided that you have the
NGO formed by students and well wishers of late Dr
with conviction. facilities needed to carry out your research. At the end of the
The lungs are larger at the bottom than at the top but M.L.Dhawale, a renowned homoeopath and educationist
most people in the world are top breathers, living on the after his demise in 1987. day, you simply need to be lucky. You can get lucky in a small
Prof. Rolf M. Zinkernagel was institution or a big one. When Peter and I were working on
shallow breaths common to the sick and the sleeping. Deep
awarded the Nobel Prize in solving the problems of MHC-restricted immune T-cell
breathing exercises increase the metabolism of the body It provides homoeopathic education, community
Medicine/Physiology in 1996, along recognition, the Eureka moment came in Canberra,
and thus burn that extra fat. medical care and research. The trust is having an existence
with Prof. Peter C. Doherty, for Australia. It was so unexpected, so serendipitous, that the
in Mumbai, Palghar, Pune, Vadodara, Bangalore and
discovering the specificity of cell- most important thing we did was not to miss it! Had we not
Breathing “from the gut”: If one can see the stomach move Kolhapur. The primary concern of MLDT is to make primary
mediated immunity. They conclusively demonstrated that discovered it, somebody else would have surely done so
in and out, one is breathing from the diaphragm. If the only and secondary health care services available and
recognition of microbial antigens by our immune system is sooner or later. Discoveries can occur anywhere.
thing that moves or expands is the chest, one is living on a accessible to the underprivileged rural population. The core
possible only in association with self-molecules, known as Is it necessary to strive for international scientific
shallow percentage of the divine potential for deep competency of all the doctors attached to the institute is
the major histocompatibility complex . exposure during one's formative years?
breathing. Deep breathing literally “massages” & moves the homoeopathy and providing voluntary/ honorary services;
soft internal organs inside the rib cage allowing the lymph they strive to serve the community through their profession. Definitely. Being in one's own geographic niche is not
Hrishikesh Kulkarni and Ajit Goenka, MBBS, spoke to him
system to rid itself of collected toxins. Only deep breathing enough. For example, I went all the way from Switzerland to
on his work, life, and beliefs after his lecture on "Why Do We
allows to tap the “bonus power” of the lower lungs. The institute has been functional in rural health care Canberra because I wanted to compare cell-mediated
Not Have a Vaccine?" at the 57th Meeting for Nobel
activity for over two decades, and has established immunity vs antibody-effector mechanisms in infectious
Laureates and Students in Lindau, Germany, in July 2007.
Neonates instinctively breathe deeply; watch and operational health care models in the form of homoeopathic disease models, such as Salmonella and Listeria. These
learn at the next opportunity. We actually “learn” how to hospitals and clinics at various locations. Community weren't available in our laboratory back then. Dr. Robert
“shallow breathe” & rob ourselves of the breath of life. development activities in the above stated regions have Blanden was already working on this in the Department of
Dr. Zinkernagel, which arm of the human immune
Singers, stage performers, broadcast announcers & become an integral part of the rural services and are Microbiology in Canberra, so I joined him. After that, I met
response has the potential to protect against diseases,
professional athletes pay large sums to voice and breathing undertaken with the help of a team of social scientists Pete, who was working on immune responses to the
such as HIV?
coaches to learn how to breathe, project the voice, & achieve representing the TISS (Tata Institute of Social Sciences) and lymphocytic choriomeningitis virus. While he did the
Antibodies. They are the key. The course of any infection
maximum strength through diaphragm breathing. MS University, Vadodara. immunopathologic analyses with the brain and the
depends on the host's response, and I believe that this has to
be through antibodies. cerebrospinal fluid, I could do the cytotoxicity assays with the
Here are a few steps to get started: The educational activities include PG Training prior experience I had from Lausanne, Switzerland. Through
courses for qualified homoeopathic doctors. Smt. Malini our work, we discovered MHC restriction. Moreover, I met
What about the role of regulatory T cells then?
!Sit or lie down and relax. Kishore Sanghvi hospital and college at Sumeru, district some of the people who influenced my life the most during
In my opinion, there is no such thing as a regulatory T cell.
Vadodara is another proud achievement providing excellent my stint in the Scripps Clinic, La Jolla, California. Science is
!Place a hand on the abdomen to see if it expands as you and qualitative care at most cost effective rates. HIV, SARS, multiple Drug-resistant tuberculosis, Ebola - one of the most international activities there is. It can never
breathe. If only the chest moves with the breaths, then it is be restricted to a single laboratory or even a nation, if
- the list is endless. We never had them until a few years
“shallow breathing”. The Pune branch of the institute has been in action progress is to occur.
ago. Why do we continue to grapple with all of these
since 1995 and the seed of the charitable activity sown in
diseases despite our scientific prowess? Life After the Nobel
!Breathe deeply through the mouth, “all the way down to the 1995 in the form of the first charitable activity at Nigdi, has This is simply because the life span of human beings has far
belly button”. The abdomen should rise with inhalation. Hold now grown into a huge tree and spread out all across Pune How does your life after the Nobel Prize compare with
exceeded what it was intended for. The main function of
the breath for a few seconds, and then exhale slowly and district. The trust presently runs 3 charitable clinics in the the earlier routine?
human beings in evolution is procreation, which is usually
fully. Learn to recognize the sounds and sensations of long, urban slums of pune, ICR homoeopathic specialty centre, a It really hasn't changed anything for me, but that is
completed by the 25th year of age. With our scientific
slow, deep breaths. 10 bedded nursing home which was set up in April 2001 at
prowess, we have prolonged our age, thus inviting a host of because I haven't let it. I admit that there is pressure to
Pimpri & has since been serving the industrial working class
new diseases. I would add autoimmune diseases to the ones come out with better results. We have done more research
!With practice, one may will relearn the natural process of and the lower income groups in the suburbs of Pimpri and that you have mentioned. However, from an evolutionary on immunologic memory, the role of the immune response
breathing the way it happens in neonatal period boosting the Chinchwad. A semi-charitable homoeopathic clinic set up in in autoimmunity, and the development of better vaccines
point of view, this is perfectly fine. Most of the diseases affect
immunity & increasing the metabolism thus controlling the Pirangut for the last 3 years has received excellent response for hepatitis B and C and HIV, but none of them are as
man after the age of 25, by which he has procreated in any
weight. and is source of reliable health care for many in the vicinity.
case. So it doesn't really matter if you die after then; your fundamental as the discovery [of MHC restriction] in itself.
contribution to evolution is complete! The irrational behavior Our work with MHC restriction gave a biological role to this
Editor’s remarks: Of course, it’s strongly recommended to A mobile clinic visits 5 villages on 3 routes every
of human beings has also significantly contributed to the system, which till then was only associated with
consult your physician before embracing any type of therapy week, taking quality health care services to the doorstep of
above-mentioned predicaments. transplantation. Even Nobel Prize winners do not get
or exercise regimen. It must be understood that pregnant the poor villagers who cannot afford to travel to the city for
better with age!
women breathe predominantly from the chest so as to make treatment. Often patients requiring hospitalization have been
Dr. Zinkernagel, not many of us will be comfortable with (These are Excerpts only. If you are interested in the Full
way for the expanding uterus in the abdominal cavity. treated at no cost in MLDT nursing homes and free
the idea of dying at around 25-30 years of age or, for that interview , you may access it at
Caution should be exercised if the patient has any homoeopathic camps, cataract surgery camps and the like
matter, not taking antibiotics for bacterial meningitis. http://www.medscape.com/viewarticle/564375)
respiratory illness or any situation where increasing the intra- are activities commonly taken up by the trust. All in all this is
Well, that's what is in nature's best interests. Regardless, the
abdominal pressure is contraindicated. Further, negative one trust which believes and implements the motto of WHO
fact remains that, with medical advancement, something like
intra-thoracic pressure improves blood flow to heart “Health for all” in toto.
that isn't really going to happen and hence, we will keep
increasing the pre-load. Thus this should be avoided in
suffering from such disease.
related cardiac problems. Contact Person: Dr. Amol Dighe
amoldighe72@gmail.com

KWMPA Newsletter KWMPA Newsletter

 Page:4 Page: 5

From the Editor’s Desk: Know your colleagues

Role of the Quality of
Healthcare Providers in the
Quality of Healthcare
By Dr Saurabh Bhatia (s.bhatia@webcyte.biz)
When I was a child, I often used to
hear about seriously ill acquaintances
being taken to USA for advanced
treatment. Over the past decade, we
have witnessed a reverse influx in the
f o r m o f M e d i c a l To u r i s m .
India, among others, is a LCC or 'Low
Cost Country' where almost anything can
be done at a fraction of cost compared
to west. Coupled with this, the health
infrastructure of the west has been
stretched to its limits; Medicare and
Medicaid are facing cash crunch while
NHS of UK has egregious waiting lists.
Propelled by this patients have been
driven in droves to India .
The question is that while they do
come for cheap treatment, do they also
come for sub-standard treatment,
knowing that our IMR is at 54.63(2006)
(41st rank globally)? Though the answer
to this question is perhaps 'no', because
they still come to the best of hospitals of
India, the overall quality of care in India
remains questionable. Medical tourism
can be seen as a new industry for the
doctors to milk. But it will not work out
unless we are able to provide doctors of
international quality. Merely state of the
art equipment cannot suffice.
So are our doctors’ skill
set and competence equivalent to that of
international physicians, in general?
Western high quality of care is partly
delivered due to a continuously educated
doctor. The doctors in west need to
upgrade their skills continually. A
compulsory need to maintain CME hours
every year and periodical licensing
exams have drilled quality
consciousness among doctors.
Compare this to our lackadaisical
system where after doing medicine 35
years ago, doctors are left to their own
devices to upgrade skills. Unfortunately
this upgradation usually comes at the
cost of biased education to the doctor,
delivered through sponsorships with
vested interests.
Editor's quest: Should doctors in India
be required to compulsorily appear for
licensing exam every five years and
maintain minimum CME credits for every
year?
You may cast your vote
on our website KWMPA.co.cc or SMS
"EQ-Y" or "EQ-N" at 09881148282.
KWMPA has been in existence for over a decade. We have members of
every age group and specialities. While the older members are well versed
with each other the newer ones have not been able to make as many social
inroads as they might have hoped for.
In order to promote camaraderie and better acquaintance, we have
decided to run this column where we’ll write 50-75 words about members of
KWMPA; starting from newest members backwards. This will help everyone
know who all have joined newly and the older members can take appropriate
steps to not only initiate the new members into the community but to also
make them feel welcome and comfortable.
To begin with, we ‘d request all those members who have joined us in
last 2 years to send a small 50-75 word write up about themselves. This may
include their professional capability/ interest as well as personal things like
hobbies, societies, NGO involvement etc. (No political inclinations please).
It’d be nice to include a passport size photograph for others to relate and
identify the person immediately.
We decided not to carry out any introductions in this edition because
we had not been able to communicate this intention to all the members and
therefore to keep it fair and free, we decided to publish them from next issue
onwards.
So hurry and send your profiles to the editor Dr Saurabh Bhatia at
s.bhatia@webcyte.biz
Kamal Hospital
Dr Vaishali Chavan, MD, DGO, DNB, DFP
(Infertility and Laparoscopic surgery)
Consultant Gynecologist, Ruby Hall Clinic
Dr Raj Chavan, MS, DNB (ENT)
Micro ear surgery
Endoscopic nasal surgery
Consultant, Jehangir Hospital
Balaji Shelter, 47/3, Wanowrie, Pune-40
Call: 26875752
Open 24 Hours
All Laparoscopic and Endoscopic
surgery facilities available.
Continued Medical Education
Long term outcomes from the IMPACT randomised trial for depressed elderly patients in primary care
Enid M Hunkeler,Wayne Katon, Lingqi Tang, John W Possible mechanisms of action
Williams Jr, Kurt Kroenke, Elizabeth H B Lin, Linda H
Harpole, Pat Arean, Stuart Levine, Lydia M Grypma, William IMPACT actively engaged an often reluctant population in
A Hargreaves, Jürgen Unützer (Excerpts only) Full CME at effective depression treatments. Patients appreciated
BMJ, doi:10.1136/bmj.38683.710255.BE (published 20 January 2006)
receiving medical and psychological care in primary care.
Objective To determine the long term effectiveness of
They benefited from an ongoing, therapeutic relationship
collaborative care management for depression in late life.
with a depression care manager, who followed a stepped
Design Two arm, randomised, clinical trial; intervention one
care treatment protocol driven by clinical outcomes
year and follow-up two years.
Perhaps because of IMPACT’s emphasis on relapse
Introduction
prevention, even 12 months after the intervention ended,
IMPACT patients reported higher rates of antidepressant
Among the one in 10 older primary care patients with
use, greater self efficacy in managing their depression, and
depression, only a small fraction receives adequate
better depression outcomes than controls. IMPACT’s NNT
treatment in primary care or sees a mental health specialist.
of 4 at 12 months shows a strong clinical effect. The later
Although treatment of depression in primary care has
numbers needed to treat—6 at 18 months, and 9 at 24
improved, few improvements deal with the specific needs of
months—although higher, show that the clinical effect was
elderly patients.
substantial and sustained.
In 2002, one year findings were published from the
“Improving Mood Promoting Access to Collaborative Care What is already known on this topic
Treatment” programme (IMPACT), an intervention
designed specifically to tackle unmet needs of elderly !People over age 60 often receive inadequate treatment for
depression in primary care
depressed patients.
We report the long term (18 month and 24 month) results of
!Organized, multifaceted, and tailored depression
treatment programs are promising.
the IMPACT trial. Our hypothesis was that, even a year after !IMPACT produced favorable results during the one year
the intervention ended, intervention patients would intervention.
!It is not known if these promising results endure.
experience more enduring health benefits than controls.
Intervention What this study adds
Acute depression care IMPACT care was delivered by a team: a
!Tailored collaborative care actively engages people over
depression care manager (usually a primary care nurse), the age 60 in depression treatment and delivers important
patient’s primary care doctor, a consulting psychiatrist, and a benefits that persist at least one year after the completion of
liaison primary care doctor. For 12 months, IMPACT patients
the intervention program.
received proactive depression treatment in primary care.
Treatment options included pharmacotherapy, behavioural !IMPACT may show the way to less depression and
activation, and problem solving treatment (a brief, behaviour healthier lives for millions.
based psychotherapy). Treatment was adjusted according to a
stepped care protocol during weekly reviews by the depression
care manager and psychiatrist. Consulting psychiatrists saw about Other studies
10% of patients, typically treatment nonresponders. Two studies showed that IMPACT’s success may hinge on
its seamless integration into primary care and, perhaps
Discussion more importantly, the patient’s relationship with the
IMPACT collaborative care delivered long term
depression care manager. The PRISMe study showed that
improvements in antidepressant use, patient satisfaction, older patients are more likely to engage in depression
and clinical outcomes. For two years, IMPACT patients were treatment when it is offered in primary care. The nurse
less depressed, functioned better physically, enjoyed a telehealth study showed the importance of a therapeutic
better quality of life, and were more satisfied with their relationship with a skilled and empathetic care manager in
depression care. This was true for both sexes, all age primary care. Two trials in mixed aged populations show
groups, ethnicities, degrees of depression, and physical that collaborative care can reduce depression over the long
comorbidities. Although the benefits of IMPACT attenuated term, two to five years. IMPACT extends these findings to
at 18 and 24 months, significant health benefits endured
even one year after IMPACT resources were withdrawn.
elderly populations. IMPACT also improved physical
functioning and quality of life.

KWMPA Newsletter KWMPA Newsletter