Collaborative Care: Depression Initiative
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Collaborative Care: Depression Initiative in Primary care (CC: DIP) Van der Feltz-Cornelis CM, Van Marwijk HWJ, Huijbregts KML, IJff MA, Nijpels G, Beekman AJ. Screening Procedure: Fase1: Screening with PHQ-9 using the GP’s database. Fase2: Classification with MINI-

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Objective: The study examines whether the treatment of depression with treatments

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Objective the study examines whether the treatment of depression with treatments

Collaborative Care: Depression Initiative

in Primary care (CC: DIP)

Van der Feltz-Cornelis CM, Van Marwijk HWJ, Huijbregts KML, IJff MA, Nijpels G, Beekman AJ

  • Screening Procedure:

  • Fase1: Screening with PHQ-9 using

  • the GP’s database.

  • Fase2: Classification with MINI-

  • Neuropsychiatric interview (DSM IV-

  • criteria)

  • Depressive symptoms must last longer

  • than 6 months or must be

  • accompanied by dysfunctioning

  • Fase 3: Conversation with GP followed

  • by contracting and start of CC-

  • intervention

  • Questionnaires

  • - IDS-SR - DESS

  • - TIQ-P- SF36

  • PRODISQ- EQ-D5 (Euroqol)

  • PDRQ9- CSQ8

  • Holmes en Rahe scale

  • Outcome measures:

  • Reduction of depressive

  • symptoms (primary outcome)

  • 2. Cost-effectivity

  • 3. Quality of life

  • 4. Adherence and compliance to

  • treatment.

  • 5. (Possible) preferences of the

  • patient

  • 6. Patient-doctor relationship

Objective:

The study examines whether the

treatment of depression with treatments

from the guideline according to a

collaborative care (CC) model [1,2]is

effective compared to care as usual

(CAU) in terms of a reduction of

depressive symptoms.

Principal elements in the CC model are:

A. Contracting of the treatment plan by the

General Practitioners (GPs) with the patient

B. Adherence improving strategies for GPs

and casemanager

C. Problem Solving Treatment (PST) [3]

D. An antidepressant algorithm for the GP

setting [4]

Design:

- Two-armed cluster randomised trial in

40 GP practices (figure 1) [5].

- Stratification for comorbid medical illness

- Three regions: Amsterdam, Hoorn

and West Friesland.

- In cooperation with the department of

General Practice, VU University

Medical Center, Amsterdam (EMGO).

- 2 x 120 patients

References:

1. Van der Feltz-Cornelis CM et al. (2006). Depressie initiatief. Depressie management in Nederland. Trimbos-instituut.

2. Bodenheimer T (2005). Helping Patients Improve Their Health-Related Behaviors:What System Changes Do We Need? Diseasemanagement, 8(5), 319-329.

3. Mynors-Wallis LM, Gath DH, Day A, et al. (2000). Randomised controlled trial of problem solving treatment, antidepressant medication, and combined treatment for mayor depression in primary care. BMJ, 320, 26-30.

4. Trivedi MH, Rush AJ, Crismon ML, et al. (2004). Clinical Results for patients With Major Depressive Disorder in the Texas Medication Algorithm Project. Arch Gen Psychiatry, 61, 669-680.

5. Van der Feltz-Cornelis CM & Adèr HJ (2000). Randomization in psychiatric interventionresearch in the general practice setting. International Journal of Methods in PsychiatricResearch, 9 (3), 134-142

Contact: Marjoliek IJff, [email protected] & Klaas Huijbregts, [email protected]


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