Translating evidence-based depression management services to community-based primary care practices
Translating evidence-based depression management services to community-based primary care practices
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DOI：
10.1111/j.0887-378x.2004.00326.x
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发表时间：
2004-01-01
影响因子：
6.6
通讯作者：
Pincus, HA
中科院分区：
文献类型：
--
作者：
Kilbourne, AM;Schulberg, HC;Pincus, HA
随机对照试验已经证明了在初级保健环境中使用治疗模式治疗重度抑郁症的有效性和成本效益。尽管如此，将这些模式转化为日常初级保健的持久变化已被证明是困难的。各种卫生系统和组织障碍阻碍了这些模式融入初级保健环境。本文讨论了在社区基础的初级保健实践中引入和维持循证抑郁症管理服务的障碍，并提出了基于罗伯特伍德约翰逊基金会抑郁症初级保健计划的组织和财务解决方案。它侧重于战略，以改善抑郁症护理的基础上适应慢性病护理模式的医疗环境，并讨论了实施循证抑郁症护理的挑战，因为心理健康和一般医疗保健之间的结构，财务和文化的分离。
Randomized controlled trials have demonstrated the efficacy and cost-effectiveness of using treatment models for major depression in primary care settings. Nonetheless, translating these models into enduring changes in routine primary care has proved difficult. Various health system and organizational barriers prevent the integration of these models into primary care settings. This article discusses barriers to introducing and sustaining evidence-based depression management services in community-based primary care practices and suggests organizational and financial solutions based on the Robert Wood Johnson Foundation Depression in Primary Care Program. It focuses on strategies to improve depression care in medical settings based on adaptations of the chronic care model and discusses the challenges of implementing evidence-based depression care given the structural, financial, and cultural separation between mental health and general medical care.