PRogram In Support of Moms (PRISM): a pilot group randomized controlled trial of two approaches to improving depression among perinatal women.
PRogram In Support of Moms (PRISM): a pilot group randomized controlled trial of two approaches to improving depression among perinatal women.
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DOI：
10.1080/0167482x.2017.1383380
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发表时间：
2018-12
期刊：
影响因子：
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通讯作者：
Allison J
中科院分区：
文献类型：
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作者：
Byatt N;Moore Simas TA;Biebel K;Sankaran P;Pbert L;Weinreb L;Ziedonis D;Allison J
该初步研究旨在通过以下方式为更大规模的有效性试验提供信息：（1）评估支持母亲的PRogram（PRISM）和我们的研究程序的可行性;以及（2）确定PRISM与积极对照组（仅针对母亲的马萨诸塞州儿童访问精神病学计划（MCPAP））相比，改善围产期妇女抑郁症的程度。四个实践被随机分配到PRISM或MCPAP单独为母亲，全州电话围产期精神病学计划。PRISM包括MCPAP为妈妈加上实施援助与当地冠军，培训，并执行办公室提示和程序，以加强抑郁症筛查，评估和治疗。在妊娠期招募爱丁堡产后抑郁量表（EPDS）≥ 10分的患者，并在基线和产后3-12周完成EPDS和结构化访谈。在MCPAP单独治疗中，患者（n = 9）的EPDS评分从15.22改善至10.11（p = 0.010），而在PRISM治疗中，患者（n = 21）的EPDS评分从13.57改善至6.19（p = 0.001）;组间差异为2.27（p = 0.341）。PRISM有利于患者、临床医生和支持人员。PRISM和MCPAP单独用于母亲改善抑郁症状严重程度和EPDS >10的女性百分比。由于样本量小相关的把握度有限，组间改善差异无统计学显著性。
This pilot study was designed to inform a larger effectiveness trial by: (1) assessing the feasibility of the PRogram In Support of Moms (PRISM) and our study procedures; and, (2) determining the extent to which PRISM as compared to an active comparison group, the Massachusetts Child Access Psychiatry Program (MCPAP) for Moms alone, improves depression among perinatal women. Four practices were randomized to either PRISM or MCPAP for Moms alone, a statewide telephonic perinatal psychiatry program. PRISM includes MCPAP for Moms plus implementation assistance with local champions, training, and implementation of office prompts and procedures to enhance depression screening, assessment and treatment. Patients with Edinburgh Postnatal Depression Scales (EPDS) ≥ 10 were recruited during pregnancy, and completed the EPDS and a structured interview at baseline and 3-12 weeks’ postpartum. Among MCPAP for Moms alone practices, patients’ (n = 9) EPDS scores improved from 15.22 to 10.11 (p = 0.010), whereas in PRISM practices patients’ (n = 21) EPDS scores improved from 13.57 to 6.19 (p = 0.001); the between groups difference-of-differences was 2.27 (p = 0.341). PRISM was beneficial for patients, clinicians, and support staff. Both PRISM and MCPAP for Moms alone improve depression symptom severity and the percentage of women with an EPDS >10. The improvement difference between groups was not statistically significant due to limited power associated with small sample size.