Improving Depression Care - National Depression Management Leadership Initiative Follow-up Study of Sustainability and Spread

Study Description and Methods

In this follow-up of the “National Depression Management Leadership: Improving Depression Care” study, we sought to examine how well practices maintained their depression care improvements. Through telephone interviews, we examined whether the practice continued to use PHQ9 in routine care of patients, if they committed to improve its capacity to provide chronic care systems for depression, and its capability to make and sustain this improvement.

Specific Aims and Objectives

Examine sustainability of change and patterns of spread among practices that have participated in the "National Depression Management Leadership Initiative: Improving Depression Care" project 20 months after the conclusion of the project in April 2006, including:

  • Sustainability of what practices have learned during the main project, including use of PHQ9 as a routine part of care, patient self-management, tracking and care management, and implementation of practice change techniques
  • Spread within practice to other clinicians
  • Spread within practice to other medical or psychiatric conditions
  • Spread to other practices and across specialties

Timeline

This study was conducted from November 29, 2007 through August 28, 2008.

Status

This project is currently under analysis, and a manuscript is in press.

Contact Information

For additional information about this study, please contact:

Debbie Graham
Principal Investigator
AAFP National Research Network
800-274-3949, x3176
dgraham@aafp.org

Key Findings and Publications

Practices demonstrated a high degree of long-term sustained improvement in depression care with the exception of tracking and care-management. Tracking and care-management may be a more challenging innovation to sustain. We hypothesize that sustaining complex depression care innovations may not be a passive process and may require active management by the practice.

Sustainability of Depression Care(8 page PDF) -- Nease DE, Nutting PA, Graham DG, et al. Sustainability of Depression Care Improvements: Success of a Practice Change Improvement Collaborative. J Am Board Fam Med. 2010;23(5):598-605. (PDF 8 pages)


This study was funded by grants from Wyeth Pharmaceuticals and Forest Laboratories, Inc.