Postpartum Depression in Primary Care: Translating Screening and Management (TRIPPD)

Study Description and Methods

This is a randomized controlled trial (RCT) to test the impact of translation of a universal screening and follow-up program for postpartum depression (PPD) versus usual care in family physicians' offices. The study population is drawn from community-based primary care practices in practice-based research networks, representing 46 states and an ethnically, economically, and geographically diverse group of postpartum women.

Specific Aims and Objectives

Our specific aims are:

  1. To assess the impact of a universal PPD screening and follow-up management program on patient-oriented outcomes associated with PPD;
  2. To assess the impact of a universal PPD screening and follow-up management program on practice-based process measures associated with PPD; and
  3. To explore the impact of practice characteristics on the translation of research regarding a PPD screening and follow-up management program.

Timeline

This project was conducted from September 30, 2005, through September 29, 2010.

Status

This project is currently under analysis. See below for research findings.

Contact Information

For additional information about this study, please contact:

Debbie Graham, MSPH
Senior Scientist
AAFP National Research Network
1-800-274-2237, x3176
dgraham@aafp.org

Craig Smail, MSc
Research Project Coordinator
AAFP National Research Network
1-800-274-2237, x3185
csmail@aafp.org

Barbara Yawn, MD, MSc
Principal Investigator
1-507-287-2758
byawn@olmmed.org

Postpartum Depression Toolkit

Included in the Postpartum Toolkit are documents and information used and developed during the TRIPPD study, such as educational slides to explain screening and follow-up of postpartum depression; tools used for screening, diagnosis, selecting therapy, facilitating nurse follow-up calls, and facilitating patient self-care; and recommendations for monitoring the progression of depressive symptoms.

We hope you find these resources helpful when diagnosing, treating, and monitoring postpartum depression in your practice.

Findings and Publications

Postpartum depression screening is feasible in primary care practices, and for most women, the Edinburgh Postnatal Depression Scale (EPDS) and Patient Health Questionnaire (PHQ-9) scores were concordant. Further work is required to identify reasons for the 17% discordant scores as well as to provide definitive recommendations for PHQ-9 scores of 5 to 9 (J Am Board Fam Med. 2009;22(5):483–491).

Access the complete manuscripts:

Communications in the Key to Success in Pragmatic Clinical Trials in Practice-based Research Networks (PBRNs)(8 page PDF). Bertram S, Graham DG, Kurland M, et al. J AM Board Fam Med. 2013;26(5):571-8.

Postpartum Depression: Screening, Diagnosis, and Management Programs 2000 through 2010.(9 page PDF) Yawn BP, Olson AL, et al. Depression Research and Treatment. Volume 2012. Article ID 363964. (PDF 9 pages)

Postpartum Depression Screening and Management.(10 page PDF)
Yawn BP, Dietrich A, Wollan P, et al. TRIPPD: A practice-based effectiveness study of postpartum depression screening and management. Ann Fam Med. 2012;10(4):320-329. (PDF 10 pages)

Practice Benefit from Participating in a PBRN study of Postpartum Depression.(10 page PDF) Yawn BP, Pace WD, Dietrich AJ,et al. Practice benefit from participating in a PBRN study of postpartum depression: A National Research Network (NRN) report. J Am Board Fam Med. 2010;23(4):455-464. (PDF 10 pages)

TRIPPD EDPS vs PHQ9 Complete Manuscript.(9 page PDF) Yawn BP, Pace WD, Wollan PC, et al. Concordance of Edinburgh Postnatal Depression Scale (EPDS) and Patient Health Questionnaire (PHQ-9) to assess increased risk of depression among postpartum women. J Am Board Fam Med. 2009;22(5):483-491. (PDF 9 pages)

Immediate Action Protocol.(4 page PDF) Yawn BP, Dietrich AJ, Wollan PC, et al. The IAP: A simple tool to guide assessment and immediate action for suicidal ideation. Family Practice Management. 2009;16(5):17-20. (PDF 4 pages)

TRIPPD PBRN-IRB Complete Manuscript.(8 page PDF) Yawn BP, Graham DG, Bertram SL, et al. Practice-based research network studies and institutional review boards: two new issues. J Am Board Fam Med. 2009;22(4):453-460. (PDF 8 pages)


This project was funded by a grant from the Agency for Healthcare Research and Quality.