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VitalSign6: A Primary Care First (PCP-First) Model for Universal Screening and Measurement-Based Care for Depression

1
Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
2
Icahn School of Medicine at Mount Sinai, New York City, NY 10029, USA
3
Delivery System Improvement, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
4
Department of Psychiatry, Duke Medical School, Durham, NC 27710, USA
5
Department of Psychiatry, Texas Tech Health Sciences Center, Permian Basin, TX 79763, USA
6
Duke-National University of Singapore, Singapore 168753, Singapore
7
Office of Communications, Marketing, and Public Affairs, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
*
Author to whom correspondence should be addressed.
Deceased.
Pharmaceuticals 2019, 12(2), 71; https://doi.org/10.3390/ph12020071
Received: 28 February 2019 / Revised: 3 May 2019 / Accepted: 8 May 2019 / Published: 14 May 2019
(This article belongs to the Special Issue Antidepressants: Mechanistic Insights and Future Directions)
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Abstract

Major depressive disorder affects one in five adults in the United States. While practice guidelines recommend universal screening for depression in primary care settings, clinical outcomes suffer in the absence of optimal models to manage those who screen positive for depression. The current practice of employing additional mental health professionals perpetuates the assumption that primary care providers (PCP) cannot effectively manage depression, which is not feasible, due to the added costs and shortage of mental health professionals. We have extended our previous work, which demonstrated similar treatment outcomes for depression in primary care and psychiatric settings, using measurement-based care (MBC) by developing a model, called Primary Care First (PCP-First), that empowers PCPs to effectively manage depression in their patients. This model incorporates health information technology tools, through an electronic health records (EHR) integrated web-application and facilitates the following five components: (1) Screening (2) diagnosis (3) treatment selection (4) treatment implementation and (5) treatment revision. We have implemented this model as part of a quality improvement project, called VitalSign6, and will measure its success using the Reach, Efficacy, Adoption, Implementation, and Maintenance (RE-AIM) framework. In this report, we provide the background and rationale of the PCP-First model and the operationalization of VitalSign6 project. View Full-Text
Keywords: depression; screening; measurement-based care; primary care; mental health depression; screening; measurement-based care; primary care; mental health
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
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MDPI and ACS Style

Trivedi, M.H.; Jha, M.K.; Kahalnik, F.; Pipes, R.; Levinson, S.; Lawson, T.; Rush, A.J.; Trombello, J.M.; Grannemann, B.; Tovian, C.; Kinney, R.; Clark, E.W.; Greer, T.L. VitalSign6: A Primary Care First (PCP-First) Model for Universal Screening and Measurement-Based Care for Depression. Pharmaceuticals 2019, 12, 71.

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