@article{d7ea0148c5fb456c893301d608630ae2,
title = "Vitalsign6: A primary care first (PCP-first) model for universal screening and measurement-based care for depression",
abstract = "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.",
keywords = "Depression, Measurement-based care, Mental health, Primary care, Screening",
author = "Trivedi, {Madhukar H.} and Jha, {Manish K.} and Farra Kahalnik and Ronny Pipes and Sara Levinson and Tiffany Lawson and {John Rush}, A. and Trombello, {Joseph M.} and Bruce Grannemann and Corey Tovian and Robert Kinney and Clark, {E. Will} and Greer, {Tracy L.}",
note = "Funding Information: Acknowledgments: The VitalSign6 program was funded in part by the Center for Depression Research and Clinical Care (CDRC), the Rees-Jones Foundation, the Meadows Foundation, and the Hersh Foundation. The content is solely the responsibility of the authors and does not necessarily represent the official views of the various funding organizations. The Intellectual Property of VitalSign6 belongs to the University of Texas Southwestern Medical Center (Principal Investigator-Trivedi). All proprietary tools and methods used in VitalSign6 are owned by the University of Texas Southwestern Medical Center. While there are currently no plans, the University of Texas Southwestern Medical Center reserves the right to commercialize VitalSign6 in the future. We wish to thank the participants, families, staff, and colleagues who made this project possible. Finally, Bruce D. Grannemann, M.A., sadly died in the course of this project, but his efforts, energy, and dedication were invaluable for the research. Funding Information: Conflicts of Interest: Trivedi has received research support from NIMH, NIDA, J&J, Janssen Research and Development LLC; has served as a consultant for Alkermes Inc., Allergan, Arcadia Pharmaceuticals Inc., AstraZeneca, Lundbeck, Medscape, MSI Methylation Sciences Inc., Merck, Otsuka America Pharmaceuticals Inc., and Takeda Pharmaceuticals Inc. Jha has received contract research grant from Acadia Pharmaceutical and Janssen Research. Rush has received consulting fees from Akili, Brain Resource Inc., Compass Inc., Curbstone Consultant LLC., Emmes Corp, Holmusk, Inc., Liva-Nova, Sunovion, Takeda USA, Taj Medical; speaking fees from Liva-Nova; royalties from Guilford Press and the University of Texas Southwestern Medical Center, Dallas, TX. (for the Inventory of Depressive Symptoms and its derivatives). He is also named co-inventor on two patents: U.S. Patent No. 7,795,033: Methods to Predict the Outcome of Treatment with Antidepressant Medication, Inventors: McMahon FJ, Laje G, Manji H, Rush AJ, Paddock S, Wilson AS and U.S. Patent No. 7,906,283: Methods to Identify Patients at Risk of Developing Adverse Events During Treatment with Antidepressant Medication, Inventors: McMahon FJ, Laje G, Manji H, Rush AJ, Paddock S. Trombello currently owns stock in Merck and Gilead Sciences and within the past 36 months previously owned stock in Johnson & Johnson. Greer has received research funding from NARSAD and contracted research support from Janssen Research & Development, LLC. She has received honoraria and/or consultant fees from H. Lundbeck A/S and Takeda Pharmaceuticals International, Inc. Clark, Kinney, Levinson, Lawson, Kahalnik, and Tovian, and Pipes and Grannemann have no conflicts to report. Funding Information: Funding: This research was funded in part by the Center for Depression Research and Clinical Care (CDRC), the Rees-Jones Foundation, the Meadows Foundation, and the Hersh Foundation. Publisher Copyright: {\textcopyright} 2019 by the authors. Licensee MDPI, Basel, Switzerland.",
year = "2019",
month = jun,
doi = "10.3390/ph12020071",
language = "English (US)",
volume = "12",
journal = "Pharmaceuticals",
issn = "1424-8247",
publisher = "Multidisciplinary Digital Publishing Institute (MDPI)",
number = "2",
}