• 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


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


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

    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 -- 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)

    Contact Information

    For additional information about this study, please contact:

    AAFP National Research Network
    1-800-274-2237 x3180

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