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Related Experiment Videos

Population level effectiveness of implementing collaborative care management for depression.

John C Fortney1, Mark A Enderle, Jeff L Clothier

  • 1Health Services Research and Development, Central Arkansas Veterans Healthcare System, North Little Rock, AR; South Central Mental Illness Research Education and Clinical Center, Central Arkansas Veterans Healthcare System, North Little Rock, AR; Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR.

General Hospital Psychiatry
|June 4, 2013
PubMed
Summary
This summary is machine-generated.

Depression care management is feasible, but low patient reach (10.3%) limits its overall population effectiveness. Improving reach is key to maximizing the benefits of this evidence-based practice in routine care.

Keywords:
Collaborative care managementDepressionImplementation

Related Experiment Videos

Area of Science:

  • Implementation science
  • Health services research
  • Mental health services

Background:

  • Care management for depression is effective in trials.
  • Population-level effectiveness depends on reach and clinical effectiveness.
  • Limited data exists on real-world effectiveness in routine care.

Purpose of the Study:

  • To estimate the population-level effectiveness of depression care management in routine care.
  • To assess the reach of an evidence-based practice in a real-world setting.
  • To evaluate the impact of implementation strategies on patient outcomes.

Main Methods:

  • Multisite hybrid Type 3 effectiveness-implementation study.
  • Quasi-experimental design with pre-post assessment across 22 VA clinics.
  • Medication Possession Ratios (MPRs) used to estimate treatment response.

Main Results:

  • Reach into the target population was 10.3% at implementation sites.
  • Patients at implementation sites had higher MPRs (OR=1.38, P=.01).
  • Estimated 1% point increase in response rates due to improved MPR.

Conclusions:

  • Depression care management improves outcomes for reached patients.
  • Low reach significantly reduces overall population-level effectiveness.
  • Strategies to increase reach are crucial for maximizing impact.