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Am J Manag Care. 2014 Sep;20(9):699-707.

Effective Implementation of collaborative care for depression: what is needed?

Author information

1
Health-Partners Institute for Education and Research, 8170 33rd Ave So, Mail Stop 23301A, Minneapolis, MN 55425. E-mail: robin.r.whitebird@healthpartners.com.

Abstract

OBJECTIVES:

To identify the care model factors that were key for successful implementation of collaborative depression care in a statewide Minnesota primary care initiative.

STUDY DESIGN:

We used a mixed-methods design incorporating both qualitative data from clinic site visits and quantitative measures of patient activation and 6-month remission rates.

METHODS:

Care model factors identified from the site visits were tested for association with rates of activation into the program and remission rates.

RESULTS:

Nine factors were identified as important for successful implementation of collaborative care by the consultants who had trained and interviewed participating clinic teams, and rated according to a Likert Scale. Factors correlated with higher patient activation rates were: strong leadership support (0.63), well-defined and -implemented care manager roles (0.62), a strong primary care physician champion (0.60), and an on-site and accessible care manager (0.59). However, remission rates at 6 months were correlated with: an engaged psychiatrist (0.62), not seeing operating costs as a barrier to participation (0.56), and face-to-face communication (warm handoffs) between the care manager and primary care physician for new patients (0.54).

CONCLUSIONS:

Care model factors most important for successful program implementation differ for patient activation into the program versus remission at 6 months. Knowing which implementation factors are most important for successful activation will be useful for those interested in adopting this evidence-based approach to improving primary care for patients with depression.

PMID:
25365745
PMCID:
PMC4270471
[Indexed for MEDLINE]
Free PMC Article

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