Web-Based Partners in Care for Primary Care Practices

描述（由申请人提供）：抑郁症和其他精神健康问题是最普遍和致残的疾病之一，在残疾调整生命年损失中排名第二，仅次于心血管疾病。令人惊讶的是，大多数寻求治疗的抑郁症患者使用初级保健机构进行治疗，而不是使用精神卫生服务。不幸的是，初级保健机构通常不能提供高质量的抑郁症治疗，因为初级保健医生通常没有接受过足够的抑郁症培训，也因为他们通常没有足够的时间来评估、教育、治疗和随访。为了应对这一问题，兰德公司创建了合作伙伴护理（PIC）合作护理干预，旨在为初级保健医生及其工作人员提供抑郁症检测和治疗领域的专业培训和资源。在RAND进行的一项为期5年的临床试验中，PIC被发现在改善抑郁症患者的护理质量、临床结果、心理健康功能和抑郁症患者的工作保留方面是有效的。ISA将创建一个基于网络的PIC程序的改编。基于网络的PIC培训将不仅仅是基于文本的信息的汇编，而是一种交互式的多媒体体验，将允许自主学习和更广泛地传播PIC方案。第一阶段的活动包括原型开发，与医生和管理式护理组织的访谈，对医生和护士样本进行可行性和可用性测试，以及确保第二阶段的现场测试地点。

DESCRIPTION (provided by applicant): Depression and other mental health problems are among the most prevalent and disabling disorders--ranking second only to cardiovascular conditions in loss of disability-adjusted life years. Surprisingly, the majority of people with depression, who seek treatment, use primary care settings for treatment rather than mental health service. Unfortunately, primary care settings do not typically provide a high level of quality for the treatment of depression because primary care physicians often do not receive sufficient training about depression and because they often do not have sufficient time to assess, educate, treat, and follow-up. In response to this problem, RAND created the Partners in Care (PIC) collaborative care intervention designed to provide primary care physicians and their staff with specialized training and access to resources in the areas of depression detection and treatment. In a 5-year clinical trial conducted by RAND, PIC was found to be effective in improving the quality of care for patients with depression as well as clinical outcomes, mental health functioning, and work retention of depressed patients. ISA will create a Web-based adaptation of the PIC program. The Web-based PIC training will not simply be a compendium of the text-based information, but an interactive, multimedia experience that will allow self-paced learning and broader dissemination of the PIC program. Phase I activities include prototype development, interviews with physicians and managed care organizations, feasibility and usability testing with a sample of physicians and nurses, and securing a Phase II field test site.