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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
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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


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.

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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



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