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Psychiatr Serv. 2019 Apr 26:appips201800257. doi: 10.1176/appi.ps.201800257. [Epub ahead of print]

Collaborative Care for Depression of Adults and Adolescents: Measuring the Effectiveness of Screening and Treatment Uptake.

Author information

1
Department of Psychiatry, College of Medicine (Thompson, Faig, Gupta, Pollack, Karnik) and Social Work and Community Health (Lahey, Golden), Rush University Medical Center, Chicago.

Abstract

OBJECTIVE:

This study analyzed effectiveness of screening, referrals, and treatment uptake of a collaborative care for depression intervention across 10 primary care clinics in Chicago.

METHODS:

Between November 2016 and December 2017, patients (N=25,369) were screened with the Patient Health Questionnaire-2 and the Patient Health Questionnaire-9 on the basis of an eligibility algorithm. Electronic health record data were analyzed for sample characteristics, screening rates, referrals, and treatment pathways. To identify disparities, a test of proportions was conducted between eligible and screened patients as well as referred and treated patients.

RESULTS:

Screenings, referrals, and uptake occurred proportionately across subgroups except for patients ages 12-17. Adolescent age was associated with disproportionate Patient Health Questionnaire-9 screenings and with treatment disengagement.

CONCLUSIONS:

The intervention shows promise in expanding access to care and reducing disparities. Greater access to psychotherapies and innovative treatment modalities, particularly for adolescents, may improve overall treatment uptake.

KEYWORDS:

Collaborative care; Depression; Health disparities; Population health; Primary care; Screening

PMID:
31023189
DOI:
10.1176/appi.ps.201800257

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