0
Get Alert
Please Wait... Processing your request... Please Wait.
You must sign in to sign-up for alerts.

Please confirm that your email address is correct, so you can successfully receive this alert.

Brief Reports   |    
Sustaining Practice Change One Year After Completion of the National Depression Management Leadership Initiative
Henry Chung, M.D.; Farifteh Firoozmand Duffy, Ph.D.; David J. Katzelnick, M.D.; Mark D. Williams, M.D.; Madhukar H. Trivedi, M.D.; Donald S. Rae, M.S.; Darrel A. Regier, M.D., M.P.H.
Psychiatric Services 2013; doi: 10.1176/appi.ps.201200227
View Author and Article Information

Dr. Chung is affiliated with the Department of Psychiatry, Albert Einstein College of Medicine, and with Montefiore Care Management, 200 Corporate Blvd. South, Yonkers, NY 10701 (e-mail: hchung@montefiore.org). Dr. Duffy and Dr. Regier are with the American Psychiatric Institute for Research and Education, a division of the American Psychiatric Foundation, Arlington, Virginia, where Mr. Rae, now retired, was formerly affiliated. Dr. Regier is also with the Division of Research, American Psychiatric Association, Arlington, Virginia. Dr. Katzelnick and Dr. Williams are with the Division of Integrative Behavioral Health and the Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota. Dr. Trivedi is with the Department of Psychiatry and Mood Disorders, University of Texas Southwestern Medical Center, Dallas.

Copyright © 2013 by the American Psychiatric Association

Abstract

Objective  This report describes the sustainability of quality improvement interventions for depression care in psychiatric practice one year after the completion of the National Depression Management Leadership Initiative (NDMLI) in 2006. The main intervention involved continued use of the nine-item depression scale of the Patient Health Questionnaire (PHQ-9) for routine care of patients with depressive disorders.

Methods  One year after project completion, lead psychiatrists from the 17 participating practices were surveyed about the sustainability of key practice interventions and dissemination of the interventions.

Results  All 14 practices that provided baseline and follow-up data reported sustained use of the PHQ-9 for screening, diagnosis, or monitoring purposes. Moreover, practices reported dissemination of this approach to clinicians within and outside their practices.

Conclusions  Psychiatrists reported sustainability and dissemination of PHQ-9 use one year after the conclusion of the NDMLI. The model has potential as a depression care improvement strategy and is worthy of additional study.

Abstract Teaser
Figures in this Article

Your Session has timed out. Please sign back in to continue.
Sign In Your Session has timed out. Please sign back in to continue.
Sign In to Access Full Content
 
Username
Password
Sign in via Athens (What is this?)
Athens is a service for single sign-on which enables access to all of an institution's subscriptions on- or off-site.
Not a subscriber?

Subscribe Now/Learn More

PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development.

Need more help? PsychiatryOnline Customer Service may be reached by emailing PsychiatryOnline@psych.org or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.).

Anchor for Jump
Table 1Depression care among 14 psychiatric practices at baseline and 12- and 24-month follow-ups, by key domaina
Table Footer Note

a Means represent psychiatrists’ responses to the 21-item Assessment of Clinician Depression Management (ACDM) in Psychiatry grouped in six key domains. Possible responses include 1, rarely or never, 3, middle or moderate level, and 5, routinely.

Table Footer Note

b Nine-item depression scale of the Patient Health Questionnaire

Table Footer Note

c Results for ACDM items and domains

+

References

Katon  W;  Von Korff  M;  Lin  E  et al:  Stepped collaborative care for primary care patients with persistent symptoms of depression: a randomized trial.  Archives of General Psychiatry 56:1109–1115, 1999
[CrossRef] | [PubMed]
 
Dietrich  AJ;  Oxman  TE;  Williams  JW  Jr  et al:  Re-engineering systems for the treatment of depression in primary care: cluster randomised controlled trial.  British Medical Journal 329:602, 2004
[CrossRef] | [PubMed]
 
Katzelnick  DJ;  Von Korff  M;  Chung  H  et al:  Applying depression-specific change concepts in a collaborative breakthrough series.  Joint Commission Journal on Quality and Patient Safety 31:386–397, 2005
[PubMed]
 
Wilson  T;  Berwick  DM;  Cleary  PD:  What do collaborative improvement projects do? Experience from seven countries.  Joint Commission Journal on Quality and Patient Safety 29:85–93, 2003
 
Wagner  EH;  Austin  BT;  Davis  C  et al:  Improving chronic illness care: translating evidence into action.  Health Affairs 20(6):64–78, 2001
[CrossRef] | [PubMed]
 
Duffy  FF;  Chung  H;  Trivedi  M  et al:  Monitoring depression severity: is it useful and feasible in routine psychiatric practice? Psychiatric Services 59:1148–1154, 2008
[CrossRef] | [PubMed]
 
Katzelnick  DJ;  Duffy  FF;  Chung  H  et al:  Depression outcomes in psychiatric clinical practice: using a self-rated measure of depression severity.  Psychiatric Services 62:929–935, 2011
[CrossRef] | [PubMed]
 
Bonomi  AE;  Wagner  EH;  Glasgow  RE  et al:  Assessment of chronic illness care (ACIC): a practical tool to measure quality improvement.  Health Services Research 37:791–820, 2002
[CrossRef] | [PubMed]
 
Parchman  ML;  Zeber  JE;  Romero  RR  et al:  Risk of coronary artery disease in type 2 diabetes and the delivery of care consistent with the chronic care model in primary care settings: a STARNet study.  Medical Care 45:1129–1134, 2007
[CrossRef] | [PubMed]
 
Bauer  AM;  Azzone  V;  Goldman  HH  et al:  Implementation of collaborative depression management at community-based primary care clinics: an evaluation.  Psychiatric Services 62:1047–1053, 2011
[CrossRef] | [PubMed]
 
Williams  M;  Angstman  K;  Johnson  I  et al:  Implementation of a care management model for depression at two primary care clinics.  Journal of Ambulatory Care Management 34:163–173, 2011
[PubMed]
 
Trivedi  MH;  Rush  AJ;  Gaynes  BN  et al:  Maximizing the adequacy of medication treatment in controlled trials and clinical practice: STAR(*)D measurement-based care.  Neuropsychopharmacology 32:2479–2489, 2007
[CrossRef] | [PubMed]
 
Battersby  M;  Von Korff  M;  Schaefer  J  et al:  Twelve evidence-based principles for implementing self-management support in primary care.  Joint Commission Journal on Quality and Patient Safety 36:561–570, 2010
[PubMed]
 
Trivedi  MH;  Lin  EH;  Katon  WJ:  Consensus recommendations for improving adherence, self-management, and outcomes in patients with depression.  CNS Spectrums 12(suppl 13):1–27, 2007
[PubMed]
 
Conway  PH;  Clancy  C:  Transformation of health care at the front line.  JAMA 301:763–765, 2009
[CrossRef] | [PubMed]
 
References Container
+
+

CME Activity

There is currently no quiz available for this resource. Please click here to go to the CME page to find another.
Submit a Comments
Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
Comments are moderated and will appear on the site at the discertion of APA editorial staff.

* = Required Field
(if multiple authors, separate names by comma)
Example: John Doe



Related Content
Articles
Books
APA Practice Guidelines > Chapter 0.  >
APA Practice Guidelines > Chapter 0.  >
The American Psychiatric Publishing Textbook of Psychopharmacology, 4th Edition > Chapter 7.  >
The American Psychiatric Publishing Textbook of Psychopharmacology, 4th Edition > Chapter 7.  >
Topic Collections
Psychiatric News
Read more at Psychiatric News >>
APA Guidelines
PubMed Articles