Depression in primary care: linking clinical and systems strategies

Pincus, Harold Alan; Pechura, Constance M.; Elinson, Lynn; Pettit, Amy R.

doi:10.1016/s0163-8343(01)00165-7

Cited by 108 publications

(88 citation statements)

References 40 publications

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“…7 The vast majority of those suffering from depression first seek treatment from their primary care providers. 8 As such, it has been estimated that the prevalence of depression in primary care settings is 3 times that in community samples, and rates for minor depression and dysthymia are even greater, ranging from 5% to 16% of patients. 8,9 Depressed patients treated in primary care settings receive predominantly pharmacologic therapy, with fewer receiving adjunct cognitive or behavioral interventions.…”

mentioning

confidence: 99%

“…8 As such, it has been estimated that the prevalence of depression in primary care settings is 3 times that in community samples, and rates for minor depression and dysthymia are even greater, ranging from 5% to 16% of patients. 8,9 Depressed patients treated in primary care settings receive predominantly pharmacologic therapy, with fewer receiving adjunct cognitive or behavioral interventions. 7 As a result, it is likely that many of these patients are not educated regarding nonpharmacologic strategies for managing the symptoms of their depression.…”

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confidence: 99%

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The Benefits of Exercise for the Clinically Depressed

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2004

Prim. Care Companion CNS Disord.

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mentioning

confidence: 99%

mentioning

confidence: 99%

The Benefits of Exercise for the Clinically Depressed

Craft

Perna²

2004

Prim. Care Companion CNS Disord.

470

322

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“…Additionally, screening and provider education alone have little effect on practice. 24 Pincus et al 25 described a conceptual framework for designing depression interventions driven by consideration of the "6 Ps" (patient, provider, practice, plan, purchaser, population). This model was adapted by our team for perinatal disorders (Figure 1).…”

Section: (P90)mentioning

confidence: 99%

Perinatal Disorders: Advancing Public Health Opportunities

Wisner

Scholle²,

Stein

2008

J. Clin. Psychiatry

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“…9 This five-year, $12 million program incorporates three components: demonstration projects on incentives, research projects on the value of improved care for depression in the primary care setting, and physician leadership development.…”

Section: Description Of the Programmentioning

confidence: 99%

Depression In Primary Care: Bringing Behavioral Health Care Into The Mainstream

Pincus¹,

Houtsinger²,

Bachman³

et al. 2005

Health Affairs

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The Robert Wood Johnson Foundation's national program, Depression in Primary Care: Linking Clinical and Systems Strategies, funds three related components to stimulate innovation in primary depression care. The incentives, value, and leadership components evaluate and implement strategies for financing and sustaining use of clinical best practices despite barriers created by economic and organizational structures that fragment behavioral and general health care. A challenge for policymakers is how to link depression care with the management of other chronic conditions, so that they are integrated into the quality improvement agenda of purchasers, payers, and providers without becoming submerged in health care's mainstream. Strategies, an innovative effort originating from one of the foundation's funding priorities to improve the quality of care and support for people with chronic health conditions and designed to increase the use of effective treatment models in primary care settings for patients with depression.1 The RWJF has a long-held interest in improving treatment for mental and addictive disorders; it recognizes that many people burdened by these conditions (and often co-occurring disorders such as diabetes, asthma, and congestive heart failure) seek relief in the primary care sector, labeled the "de facto mental health service system" in the United States. 2The program also recognizes that (1) depression is a serious, often chronic disease that is commonly encountered in primary care patients but often unrecognized or treated in ways that are inconsistent with evidencebased practice; (2) although models for chronic illness care have been shown to be effective in treating depression in primary care settings, systemic barriers at multiple levels operate against implementing and sustaining these models; and (3) integrating these models into everyday practice requires a multilevel clinical and systems strategy that engages all G r a n t W a t c h stakeholders, including patients, providers, practices, plans, and purchasers.Depression in Primary Care will determine whether such a coordinated approach is feasible and effective and will provide a template of best practices for other organizations to follow. The program also will assist in determining and documenting the value of treating depression in primary care and will lay the groundwork for training a new generation of primary care providers to break down the traditional mind-body barriers in public, private, and research environments. Depression And Key BarriersDepression affects ten to fourteen million Americans every year, exerting a detrimental impact on quality of life, functioning, and work productivity. 3 Models of recognition, treatment, and follow-up for depression in primary care settings have recently been developed, tested, and found effective. 4 These models, along with major advances in pharmaceutical and psychotherapeutic treatments, hold great promise for improving outcomes. But this promise has yet to be realized for most patient...

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Depression in primary care: linking clinical and systems strategies

Cited by 108 publications

References 40 publications

The Benefits of Exercise for the Clinically Depressed

The Benefits of Exercise for the Clinically Depressed

Perinatal Disorders: Advancing Public Health Opportunities

Depression In Primary Care: Bringing Behavioral Health Care Into The Mainstream

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