PMID- 20695669
OWN - NLM
STAT- MEDLINE
DCOM- 20101012
LR  - 20220318
IS  - 1091-7527 (Print)
IS  - 1091-7527 (Linking)
VI  - 28
IP  - 2
DP  - 2010 Jun
TI  - Using evidence-based quality improvement methods for translating depression 
      collaborative care research into practice.
PG  - 91-113
LID - 10.1037/a0020302 [doi]
AB  - OBJECTIVE: Translating Initiatives in Depression into Effective Solution (TIDES) 
      aimed to translate research-based collaborative care for depression into an 
      approach for the Veterans Health Administration (VA). SITES: Three multistate 
      administrative regions and seven of their medium-sized primary care practices. 
      INTERVENTION: Researchers assisted regional leaders in adapting research-based 
      depression care models using evidence-based quality improvement (EBQI) methods. 
      EVALUATION: We evaluated model fidelity and impacts on patients. Trained nurse 
      depression care managers collected data on patient adherence and outcomes. 
      RESULTS: Among 72% (128) of the 178 patients followed in primary care with 
      depression care manager assistance during the 3-year study period, mean PHQ-9 
      scores dropped from 15.1 to 4.7 (p < .001). A total of 87% of patients achieved a 
      PHQ-9 score lower than 10 (no major depression). 62% achieved a score lower than 
      six (symptom resolution). Care managers referred 28% (50) TIDES patients to 
      mental health specialty (MHS). In the MHS-referred group, mean PHQ-9 scores 
      dropped from 16.4 to 9.0 (p < .001). A total of 58% of MHS-referred patients 
      achieved a PHQ-9 score lower than 10, and 40%, a score less than 6. Over the 2 
      years following the initial development phase reported here, national 
      policymakers endorsed TIDES through national directives and financial support. 
      CONCLUSIONS: TIDES developed an evidence-based depression collaborative care 
      prototype for a large health care organization (VA) using EBQI methods. As 
      expected, care managers referred sicker patients to mental health specialists; 
      these patients also improved. Overall, TIDES achieved excellent overall patient 
      outcomes, and the program is undergoing national spread.
CI  - PsycINFO Database Record (c) 2010 APA, all rights reserved.
FAU - Rubenstein, Lisa V
AU  - Rubenstein LV
AD  - Department of Medicine and Health Services Research, VA Greater Los Angeles 
      Healthcare System, Los Angeles, CA, USA. lisa.rubenstein@va.gov
FAU - Chaney, Edmund F
AU  - Chaney EF
FAU - Ober, Scott
AU  - Ober S
FAU - Felker, Bradford
AU  - Felker B
FAU - Sherman, Scott E
AU  - Sherman SE
FAU - Lanto, Andy
AU  - Lanto A
FAU - Vivell, Susan
AU  - Vivell S
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Fam Syst Health
JT  - Families, systems & health : the journal of collaborative family healthcare
JID - 9610836
SB  - IM
MH  - *Cooperative Behavior
MH  - Depressive Disorder, Major/*therapy
MH  - Evidence-Based Practice
MH  - Humans
MH  - Information Systems
MH  - Inservice Training/organization & administration
MH  - Mental Health Services/*organization & administration
MH  - Patient Care Management/organization & administration
MH  - Primary Health Care/*organization & administration
MH  - Quality Assurance, Health Care/*organization & administration
MH  - Translational Research, Biomedical/organization & administration
MH  - United States
MH  - United States Department of Veterans Affairs/organization & administration
EDAT- 2010/08/11 06:00
MHDA- 2010/10/13 06:00
CRDT- 2010/08/11 06:00
PHST- 2010/08/11 06:00 [entrez]
PHST- 2010/08/11 06:00 [pubmed]
PHST- 2010/10/13 06:00 [medline]
AID - 2010-15711-004 [pii]
AID - 10.1037/a0020302 [doi]
PST - ppublish
SO  - Fam Syst Health. 2010 Jun;28(2):91-113. doi: 10.1037/a0020302.