STAR*D Trial Implications for Primary Care: What Family Doctors Need to Know
What does the STAR*D trial mean for primary care doctors?
STAR*D trial shows that approximately 50-55% of patients achieve remission after 2 sequential treatments, with remission rates declining from 28% at step 1 to ≤25% at step 3 and ≤10% at step 4. The largest depression treatment study (4,041 patients) found that most remissions occur after 6 weeks, and measurement-based care significantly improves outcomes compared to routine clinical care.
STAR*D works by using systematic, sequential treatment algorithms with measurement-based care, allowing patients to switch or augment treatments based on objective symptom monitoring rather than clinical intuition alone.