Systematic use of patient-rated depression severity monitoring

Is it helpful and feasible in clinical psychiatry?

Farifteh Firoozmand Duffy, Henry Chung, Madhukar Trivedi, Donald S. Rae, Darrel A. Regier, David J. Katzelnick

Research output: Contribution to journalArticle

58 Citations (Scopus)

Abstract

Objective: The gap between evidence-based treatments and routine care has been well established. Findings from the Sequenced Treatments Alternatives to Relieve Depression (STAR*D) emphasized the importance of measurement-based care for the treatment of depression as a key ingredient for achieving response and remission; yet measurement-based care approaches are not commonly used in clinical practice. Methods: The Nine-Item Patient Health Questionnaire (PHQ-9) for monitoring depression severity was introduced in 19 diverse psychiatric practices. During the one-year course of the project the helpfulness and feasibility of implementation of PHQ-9 in these psychiatric practices were studied. The project was modeled after the Institute for Healthcare Improvement Breakthrough Series. Two of the 19 practices dropped out during the course of the project. Results: By the conclusion of the study, all remaining 17 practices had adopted PHQ-9 as a routine part of depression care in their practice. On the basis of responses from 17 psychiatrists from those practices, PHQ-9 scores influenced clinical decision making for 93% of 6,096 patient contacts. With the additional information gained from the PHQ-9 score, one or more treatment changes occurred during 40% of these clinical contacts. Changing the dosage of antidepressant medication and adding another medication were the most common treatment changes recorded by psychiatrists, followed by starting or increasing psychotherapy and by switching or initiating antidepressants. In 3% of the patient contacts, using the PHQ-9 led to additional suicide risk assessment. Conclusions: The study findings suggest that adopting measurement-based care, such as using the PHQ-9, is achievable, even in practices with limited resources.

Original languageEnglish (US)
Pages (from-to)1148-1154
Number of pages7
JournalPsychiatric Services
Volume59
Issue number10
DOIs
StatePublished - Oct 2008

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Psychiatry
Depression
Antidepressive Agents
Therapeutics
Psychotherapy
Suicide
Delivery of Health Care
Health

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Systematic use of patient-rated depression severity monitoring : Is it helpful and feasible in clinical psychiatry? / Duffy, Farifteh Firoozmand; Chung, Henry; Trivedi, Madhukar; Rae, Donald S.; Regier, Darrel A.; Katzelnick, David J.

In: Psychiatric Services, Vol. 59, No. 10, 10.2008, p. 1148-1154.

Research output: Contribution to journalArticle

Duffy, Farifteh Firoozmand ; Chung, Henry ; Trivedi, Madhukar ; Rae, Donald S. ; Regier, Darrel A. ; Katzelnick, David J. / Systematic use of patient-rated depression severity monitoring : Is it helpful and feasible in clinical psychiatry?. In: Psychiatric Services. 2008 ; Vol. 59, No. 10. pp. 1148-1154.
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