Increased Depression Screening and Treatment Recommendations After Implementation of a Perinatal Collaborative Care
Emily S Miller1, William A Grobman1, Jody D Ciolino1
1Department of Obstetrics and Gynecology (Miller, Grobman, Sakowicz), Department of Psychiatry and Behavioral Sciences (Miller, Gollan, Wisner), and Department of Preventive Medicine, Division of Biostatistics (Ciolino, Zumpf), all at Feinberg School of Medicine, Northwestern University, Chicago.
Psychiatric Services (Washington, D.C.)
|May 21, 2021
Summary
Implementing perinatal collaborative care significantly improved antenatal depression screening and treatment recommendations for pregnant individuals. This approach enhances maternal mental health support within obstetric settings.
Area of Science:
- Obstetrics and Gynecology
- Perinatal Mental Health
- Healthcare Quality Improvement
Background:
- Perinatal depression affects a significant number of pregnant individuals.
- Early screening and timely treatment are crucial for maternal and infant well-being.
- Obstetric settings are key points for identifying and managing perinatal depression.
Purpose of the Study:
- To evaluate the impact of implementing a perinatal collaborative care program on depression screening and treatment recommendations.
- To assess changes in obstetric clinicians' practices regarding perinatal depression care before and after program implementation.
Main Methods:
- A cohort study design comparing care before and after the implementation of the COMPASS program (January 2015-January 2019).
- Inclusion of 7,028 women receiving prenatal care at five obstetric clinics and one hospital.
- Utilized propensity score weighting for adjusted analyses to control for covariates.
Main Results:
- Antenatal depression screening rates increased significantly from 33% to 81% after program implementation (aOR=8.5).
- Women with positive screens were more likely to receive treatment recommendations (44% to 61%; aOR=2.1).
- Combined psychotherapy and pharmacotherapy recommendations increased post-implementation.
Conclusions:
- Implementation of perinatal collaborative care is associated with improved screening for perinatal depression.
- The program led to better treatment recommendations for positive depression screens by obstetric clinicians.
- Collaborative care models enhance the management of perinatal depression within obstetric services.
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