Screening, assessment, and management of depression in VA primary care clinics
Screening, assessment, and management of depression in VA primary care clinics
复制标题
退伍军人事务部初级保健诊所的抑郁症筛查、评估和管理
DOI：
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发表时间：
2007
影响因子：
5.7
通讯作者：
I. Katz
中科院分区：
文献类型：
--
作者：
D. Oslin;J. Ross;S. Sayers;John Murphy;Vincent R Kane;I. Katz
摘要目的：该项目的目的是评估基于电话的系统临床评估服务——行为健康实验室（BHL）在初级保健中的实用性和可行性。 BHL 是一项临床服务，为初级保健提供者提供心理健康和药物滥用 (MH/SA) 症状的评估和总结，并提供治疗决策支持，包括分流至专业 MH/SA 服务。 BHL 的实施是为了协助评估在年度临床预约中抑郁症筛查呈阳性或通过常规护理发现的患者。
方法：提取 BHL 实施前 6 个月内和实施后 6 个月内对初级保健患者进行系统筛查的结果。在此期间进行的 580 项评估的描述性结果现已公布。
结果：结果表明 BHL 的实施与初级保健中筛查抑郁症患者比例的增加之间存在关联。此外，筛查呈阳性的患者比例也有所增加（2.8% vs 7.0%）。 BHL 成功地为 78% 的转介者提供了全面评估。在接受评估的人中发现了严重的同时发生的精神疾病和药物滥用。
结论：将 BHL 引入初级保健与费城退伍军人医疗中心初级保健临床实践的明显变化相关。 BHL 的广泛方法不仅发现了更多的患者，还发现了与酗酒、非法药物和自杀意念相关的显着合并症，这些症状可能在常规临床实践中被遗漏。 BHL 为初级保健中确定有 MH/SA 需求的患者提供实用、低成本的评估、监测和治疗计划方法。
AbstractOBJECTIVES: The purpose of this project was to assess the utility and feasibility of a telephone-based systematic clinical assessment service, the Behavioral Health Laboratory (BHL), in the context of primary care. The BHL is a clinical service that provides primary care providers with an assessment and a summary of mental health and substance abuse (MH/SA) symptoms and provides treatment decision support, including triage to specialty MH/SA services. The BHL was implemented to assist in the evaluation of patients who screened positively for depression at an annual clinical appointment or who were identified through routine care.
METHODS: Results from systematic screening of primary care patients were extracted during a period of 6 months prior to implementation of the BHL and after implementation of the BHL. Descriptive results of the 580 evaluations conducted during this time were available.
RESULTS: Results suggest an association between the implementation of the BHL and an increase in the proportion of patients screened for depression in primary care. In addition, there was an increase in the proportion of patients who screened positively (2.8% vs 7.0%). The BHL was successful in providing a comprehensive assessment for 78% of those referred. Significant co-occurring mental illness and substance misuse were found among those assessed.
CONCLUSIONS: Introducing the BHL into primary care was associated with an apparent change in clinical practice in primary care at the Philadelphia VA Medical Center. Not only were more patients identified, the broad-based approach of the BHL identified significant comorbidity with alcohol misuse, illicit drugs, and suicidal ideation, symptoms likely to have been missed in routine clinical practice. The BHL offers a practical, low-cost method of assessment, monitoring, and treatment planning for patients identified in primary care with MH/SA needs.
影响因子：
120.7
作者：
Wells, KB;Sherbourne, C;Rubenstein, LV
通讯作者：
Rubenstein, LV
影响因子：
120.7
作者：
Bruce, ML;Ten Have, TR;Alexopoulos, GS
通讯作者：
Alexopoulos, GS