BACKGROUND: Even with routine screening, women diagnosed with postpartum depression (PPD) often experience delays in treatment with consequences affecting mother, infant, families and communities. A collaborative care management (CCM) approach may provide more timely, effective and higher quality of care for women suffering from postpartum depression. AIMS: This study compared the outcomes of women diagnosed with depression within a year of giving birth, comparing management using a collaborative care model with routine primary care. METHODS: In a retrospective quantitative cohort pilot study (n = 78), the outcomes of days to first follow-up, one-year healthcare utilisation, remission rates and other quality metrics were investigated. RESULTS: Those who were managed with CCM had fewer days to first follow-up (6.1 versus 31.4; P < 0.01), were more likely to meet the quality metrics of three or more related contacts in the three months after diagnosis (P < 0.01), and had documented Patient Health Questionnaire (PHQ-9) or Edinburgh Postnatal Depression Scale (EPDS) measurements at 3 (P < 0.01), 6 (P < 0.01) and 12 (P < 0.01) months. With an intention to treat model, 6-month remission rates were improved with CCM (46.7 vs. 6.3%, P <0.01). Those managed collaboratively versus routinely used healthcare in the year following diagnosis at similar rates. CONCLUSIONS: A CCM model offers timelier and higher quality care to women suffering from PPD, without contributing to higher healthcare utilisation.
BACKGROUND: Even with routine screening, women diagnosed with postpartum depression (PPD) often experience delays in treatment with consequences affecting mother, infant, families and communities. A collaborative care management (CCM) approach may provide more timely, effective and higher quality of care for women suffering from postpartum depression. AIMS: This study compared the outcomes of women diagnosed with depression within a year of giving birth, comparing management using a collaborative care model with routine primary care. METHODS: In a retrospective quantitative cohort pilot study (n = 78), the outcomes of days to first follow-up, one-year healthcare utilisation, remission rates and other quality metrics were investigated. RESULTS: Those who were managed with CCM had fewer days to first follow-up (6.1 versus 31.4; P < 0.01), were more likely to meet the quality metrics of three or more related contacts in the three months after diagnosis (P < 0.01), and had documented Patient Health Questionnaire (PHQ-9) or Edinburgh Postnatal Depression Scale (EPDS) measurements at 3 (P < 0.01), 6 (P < 0.01) and 12 (P < 0.01) months. With an intention to treat model, 6-month remission rates were improved with CCM (46.7 vs. 6.3%, P <0.01). Those managed collaboratively versus routinely used healthcare in the year following diagnosis at similar rates. CONCLUSIONS: A CCM model offers timelier and higher quality care to women suffering from PPD, without contributing to higher healthcare utilisation.
Authors: Tiffany A Moore Simas; Michael P Flynn; Aimee R Kroll-Desrosiers; Stephanie M Carvalho; Leonard L Levin; Kathleen Biebel; Nancy Byatt Journal: Clin Obstet Gynecol Date: 2018-09 Impact factor: 2.190
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