这是足够的训练吗? 审查退伍军人卫生管理局对抑郁症的基于证据的心理治疗的实施情况
Princess E Ackland1, Andrea Cutting1, Michele R Spoont1
1Center for Care Delivery and Outcomes Research, Minneapolis Veterans Affairs Health Care System.
Psychological services
|November 18, 2024
概括
在退伍军人卫生管理局提供了基于证据的抑郁症心理治疗方法,但实际使用率很低. 患者和临床因素,如并发症和高患者数量,阻碍了采用这些重要的抑郁症治疗方法.
科学领域:
- 心理健康服务研究 心理健康服务研究
- 卫生服务和研究成果研究成果
- 精神病学和心理健康 精神病学和心理健康
背景情况:
- 退伍军人健康管理局 (VHA) 通过培训计划为抑郁症提供了三种基于证据的心理治疗 (D-EBP).
- 尽管有培训,但D-EBP在日常实践中的整合受到患者和临床因素的限制.
- 了解这些因素对于改善VHA内的抑郁症护理至关重要.
研究的目的:
- 评估D-EBP在VHA门诊一般心理健康 (GMH) 诊所对抑郁症的使用情况.
- 检查患者层面和临床层面因素之间的关联以及D-EBP的使用.
- 在VHA人群中,将D-EBP使用与抑郁药物使用进行比较.
主要方法:
- 一项混合方法研究确定了2022财年在VHA GMH诊所诊断患有抑郁症的患者.
- 患者变量包括人口统计,抑郁药物使用和并发症诊断.
- 临床变量包括患者数量,D-EBP临床医师能力和地理位置.
主要成果:
- 在635,653名患有抑郁症的患者中,只有2.8%接受了D-EBP会话,77.4%接受了抑郁症药物治疗.
- 较低的D-EBP使用与男性,年龄较大,患有并发症和使用抑郁药物有关.
- 患者数量较少的诊所和特定地区 (大陆,中西部) 的诊所显示D-EBP使用率较高.
结论:
- 在VHA中,D-EBP的利用率明显低于抑郁症药物的使用率.
- 临床医生面临的挑战可能来自于管理患者的并发症和高患者病例.
- 需要进一步的研究来确定有效的实施策略,以增加D-EBP的采用.
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