Vitalsign6: A primary care first (PCP-first) model for universal screening and measurement-based care for depression

Madhukar H. Trivedi, Manish K. Jha, Farra Kahalnik, Ronny Pipes, Sara Levinson, Tiffany Lawson, A. John Rush, Joseph M. Trombello, Bruce Grannemann, Corey Tovian, Robert Kinney, E. Will Clark, Tracy L. Greer

Research output: Contribution to journalArticlepeer-review

26 Scopus citations


Major depressive disorder affects one in five adults in the United States. While practice guidelines recommend universal screening for depression in primary care settings, clinical outcomes suffer in the absence of optimal models to manage those who screen positive for depression. The current practice of employing additional mental health professionals perpetuates the assumption that primary care providers (PCP) cannot effectively manage depression, which is not feasible, due to the added costs and shortage of mental health professionals. We have extended our previous work, which demonstrated similar treatment outcomes for depression in primary care and psychiatric settings, using measurement-based care (MBC) by developing a model, called Primary Care First (PCP-First), that empowers PCPs to effectively manage depression in their patients. This model incorporates health information technology tools, through an electronic health records (EHR) integrated web-application and facilitates the following five components: (1) Screening (2) diagnosis (3) treatment selection (4) treatment implementation and (5) treatment revision. We have implemented this model as part of a quality improvement project, called VitalSign6, and will measure its success using the Reach, Efficacy, Adoption, Implementation, and Maintenance (RE-AIM) framework. In this report, we provide the background and rationale of the PCP-First model and the operationalization of VitalSign6 project.

Original languageEnglish (US)
Article number71
Issue number2
StatePublished - Jun 2019


  • Depression
  • Measurement-based care
  • Mental health
  • Primary care
  • Screening

ASJC Scopus subject areas

  • Molecular Medicine
  • Pharmaceutical Science
  • Drug Discovery


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