Improving the identification and treatment of depression in low-income primary care clinics: a qualitative study of providers in the VitalSign6 program
| Autor: | Corey Tovian, Manish K. Jha, Afrida Faria, Ronny Pipes, Farra Kahalnik, E. Will Clark, Sara Levinson, Meaghan Pederson, Bruce D. Grannemann, Madhukar H. Trivedi, Katherine Sanchez |
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| Rok vydání: | 2018 |
| Předmět: |
Health Knowledge
Attitudes Practice medicine.medical_specialty Social stigma Service delivery framework Social Stigma Specialty Ambulatory Care Facilities Workflow 03 medical and health sciences 0302 clinical medicine Patient experience Humans Medicine 030212 general & internal medicine Competence (human resources) Qualitative Research Internet Primary Health Care Depression business.industry 030503 health policy & services Health Policy Public Health Environmental and Occupational Health General Medicine medicine.disease Texas Antidepressive Agents Family medicine Behavioral medicine Major depressive disorder Female 0305 other medical science business Software Program Evaluation Qualitative research |
| Zdroj: | International Journal for Quality in Health Care. 31:57-63 |
| ISSN: | 1464-3677 1353-4505 |
| Popis: | Quality problem Despite its global burden and prevalence, Major Depressive Disorder often goes undetected and untreated, and is particularly pervasive in the primary care setting. Initial assessment One in four Texans lack health insurance, and people with behavioral health disorders are disproportionately affected. It is possible to provide high-quality depression treatment in primary care settings with outcomes equal to those provided by specialty care. The Center for Depression Research and Clinical Care offered an opportunity to transform service delivery practices in underserved primary care practices to improve quality, health status, patient experience and coordination. Choice of solution A point-of-care, web-based, self-report based software program, VitalSign6, was developed to provide universal depression screening in primary care practices and assist providers in monitoring and treating patients' symptoms using principles of Measurement-Based Care. Implementation Implementation included a multi-faceted training program designed to build confidence and competence in participating clinics' medical providers and staff as well as ongoing performance improvement delivered by the VitalSign6 team. Evaluation Primary care providers (N = 11) were interviewed, using a semi-structured interview guide, with a focus on barriers and challenges to full integration, perceptions of the most/least valuable aspects of the program, and the program's impact on knowledge, attitudes and behaviors about depression screening and treatment. Lessons learned More efficient technology is needed to reduce time wasted, as is training to reduce stigma and correct misconceptions about antidepressant medications. Provider buy-in is essential. Conclusions Despite barriers, VitalSign6 increased knowledge, changed attitudes and enhanced providers' depression screening and treatment skills over time. |
| Databáze: | OpenAIRE |
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