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Evaluating the Real-World Implementation and Effectiveness of a Collaborative Care Model for Adults with Depression
Peter J Hahn1, Daniel Y Johnson1, Joanne Wang2
1Pritzker School of Medicine, University of Chicago, Chicago, Illinois, USA.
Rationale:
Over 30% of adults in the United States have symptoms of depressive or anxiety disorders. The majority of these patients are treated only in primary care and have suboptimal outcomes. The Collaborative Care Model (CoCM) is designed to address this problem.
Aims And Objectives:
This study evaluated the implementation and effectiveness of CoCM at an urban academic medical center primary care clinic.
Methods:
Retrospective chart review and analysis informed by the RE-AIM framework.
Results:
Across 148 patients, mean PHQ-9 scores decreased by 4.8 (SD, 5.8, p < 0.001) and GAD-7 scores decreased by 5.6 (SD, 5.7, p < 0.001). Overall adoption rate was 36% and differed between attending physicians/APNs (50%) and residents (32%). Implementation showed fidelity to measurement-based care, but only 40% of cases were reviewed with the psychiatrist.
Conclusion:
A real-world CoCM can improve symptoms of depression and anxiety for adults; however, trainee adoption and adherence to psychiatric case reviews may merit special attention.
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