Going to scale: re-engineering systems for primary care treatment of depression. Academic Article uri icon

Overview

abstract

  • BACKGROUND: Recent trials have shown improved depression outcomes with chronic care models. We report the methods of a project that assesses the sustainability and transportability of a chronic care model for depression and change strategy. METHODS: In a randomized controlled trial (RCT), a clinical model for depression was implemented through a strategy supporting practice change. The clinical model is evidence based. The change strategy relies on established quality improvement programs and is informed by diffusion of innovations theory. Evaluation will address patient outcomes, as well as process of care and process of change. RESULTS: Five medical groups and health plans are participating in the trial. The RCT involves 180 clinicians in 60 practices. All practices assigned to the clinical model have implemented it. Participating organizations have the potential to disseminate this clinical model of care to 700 practices and 1,700 clinicians. CONCLUSIONS: It is feasible to implement the clinical model and change strategy in diverse practices. Follow-up evaluation will determine the impact, sustainability, and potential for dissemination. Materials are available through http://www. depression-primarycare.org; more in-depth descriptions of the clinical model and change strategy are available in the online-only appendixes to this article.

publication date

  • January 1, 2004

Research

keywords

  • Depression
  • Primary Health Care
  • Systems Theory

Identity

PubMed Central ID

  • PMC1466695

Scopus Document Identifier

  • 4243190246

Digital Object Identifier (DOI)

  • 10.1370/afm.102

PubMed ID

  • 15335127

Additional Document Info

volume

  • 2

issue

  • 4