Abstract
BACKGROUND Recent trials have shown improved depression outcomes with chronic care models. We report the methods of a project that assesses the sustainability and transportability of a chronic care model for depression and change strategy.
METHODS In a randomized controlled trial (RCT), a clinical model for depression was implemented through a strategy supporting practice change. The clinical model is evidence based. The change strategy relies on established quality improvement programs and is informed by diffusion of innovations theory. Evaluation will address patient outcomes, as well as process of care and process of change.
RESULTS Five medical groups and health plans are participating in the trial. The RCT involves 180 clinicians in 60 practices. All practices assigned to the clinical model have implemented it. Participating organizations have the potential to disseminate this clinical model of care to 700 practices and 1,700 clinicians.
CONCLUSIONS It is feasible to implement the clinical model and change strategy in diverse practices. Follow-up evaluation will determine the impact, sustainability, and potential for dissemination. Materials are available through http://www.depression-primarycare.org; more in-depth descriptions of the clinical model and change strategy are available in the online-only appendixes to this article.
- Depression
- depressive disorder
- health services research, program evaluation
- primary health care
- information dissemination
- randomized controlled trials
Footnotes
Conflicts of interest: none reported
Funding support: This research is sponsored by the John D. and Catherine T. MacArthur Foundation.
Presented in part at Beyond the Clinic Walls: Expanding Mental Health, Drug and Alcohol Services Research Outside the Specialty Care System, sponsored by NIMH, NIDA, NIAA, March 11, 2003, Washington, DC.
- Received for publication May 28, 2003.
- Revision received August 25, 2003.
- Accepted for publication October 12, 2003.
- © 2004 Annals of Family Medicine, Inc.
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