Can quality improvement programs for depression in primary care address patient preferences for treatment?
Can quality improvement programs for depression in primary care address patient preferences for treatment?
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DOI：
10.1097/00005650-200109000-00004
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发表时间：
2001-09-01
期刊：
影响因子：
3
通讯作者：
Wells, KB
中科院分区：
文献类型：
--
作者：
Dwight-Johnson, M;Unutzer, J;Wells, KB
背景。抑郁症在初级保健中很常见，但充分护理的比率很低。人们对患者治疗偏好在鼓励接受护理方面的作用知之甚少。 目标。旨在检查旨在适应患者和提供者治疗选择的基于初级保健的抑郁症质量改善 (QI) 干预措施是否会增加患者进入抑郁症治疗并接受首选治疗的可能性。方法。在 46 个初级保健诊所中，通过筛查确定了当前患有抑郁症状以及终生或当前患有抑郁症的患者。通过患者自我报告在基线和 6 个月时评估治疗偏好、患者特征和抑郁症治疗的使用情况。匹配的诊所被随机分配至常规护理 (UC) 或 2 项 QI 干预措施中的 1 项。使用逻辑回归模型分析数据。结果。对于基线时未接受护理的患者，与常规护理相比，QI 干预措施增加了接受抑郁症治疗的比率（调整后的百分比：干预措施为 50.0% +/- 5.3 和 33.0% +/- 4.9，常规护理为 15.9% +/- 3.6；F = 12.973，P
BACKGROUND. Depression is common in primary care, but rates of adequate care are low. Little is known about the role of patient treatment preferences in encouraging entry into care.OBJECTIVES. To examine whether a primary care based depression quality improvement (QI) intervention designed to accommodate patient and provider treatment choice increases the likelihood that patients enter depression treatment and receive preferred treatment.METHODS. In 46 primary care clinics, patients with current depressive symptoms and either lifetime or current depressive disorder were identified through screening. Treatment preferences, patient characteristics, and use of depression treatments were assessed at baseline and 6 months by patient self-report. Matched clinics were randomized to usual care (UC) or 1 of 2 QI interventions. Data were analyzed using logistic regression models.RESULTS. For patients not in care at baseline, the QI interventions increased rates of entry into depression treatment compared with usual care (adjusted percentage: 50.0% +/- 5.3 and 33.0% +/- 4.9 for interventions vs. 15.9% +/- 3.6 for usual care; F = 12.973, P