“Depression is such a common, human thing and we see a lot of it in primary care. [This program] gets twice as many people better in half the time.”
—Elizabeth Perry, MD
The program works through an evidence-based collaborative care model. First, the primary care physician evaluates a patient to make the initial diagnosis of depression.
A patient who wishes to participate then meets regularly with a care coordinator: a specially-trained nurse or social worker who provides brief, evidence-based behavioral interventions, such as behavioral activation or problem-solving treatment.
Behavioral activation encourages people to monitor how their activities affect their moods, identify individual goals, increase engagement, and reduce the isolation that often accompanies depression. All patients have the option of taking antidepressants in addition to or instead of participating in the behavioral interventions.
The primary care physician and care coordinator follow the patient through the 6- to 9-month program. In addition, a team psychiatrist will meet with the care coordinator on a weekly basis to review their caseload of patients, focusing on patients who are not improving. When a patient “graduates,” he or she receives a summary of their individual challenges and the skills learned to manage them.
‘Twice as Many People Better in Half the Time’
Dr. Perry is excited by the program because it’s based in primary care, it empowers patients, and it’s effective.
She emphasized that there have been over 80 randomized clinical trials that show that this type of program works, citing the IMPACT trial as the largest of them.
“It gets twice as many people better in half the time,” she noted. “Depression is such a common, human thing and we see a lot of it in primary care. It’s important that we do a better job in helping people get better.”
In addition to Dr. Perry, the project’s core planning group comprises Heather Huang, MD, and Wendy Adams from the UW Department of Medicine’s Division of General Internal Medicine; and Bill Caplan, MD, and Sarah Boeding from UW Health’s Quality, Safety, and Innovation group.
The pilot is planned to roll out in June 2016 at the UW Health DeForest-Windsor and 20 South Park Clinics.
Published: April 2016