William C Torrey1, Magda Cepeda1, Sergio Castro1, Sophia M Bartels1, Leonardo Cubillos1, Fernando Suárez Obando1, Pablo Martínez Camblor1, José Miguel Uribe-Restrepo1, Makeda Williams1, Carlos Gómez-Restrepo1, Lisa A Marsch1. 1. Department of Psychiatry (Torrey, Bartels, Cubillos, Marsch) and Department of Biomedical Data Science (Camblor), Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire; Department of Clinical Epidemiology and Biostatistics (Cepeda, Castro, Gómez-Restrepo), Institute of Human Genetics (Suárez Obando), and Department of Psychiatry and Mental Health (Uribe-Restrepo, Gómez-Restrepo), Pontificia Universidad Javeriana, Bogotá, Colombia; Office for Research on Disparities and Global Mental Health, National Institute of Mental Health, Bethesda, Maryland (Williams).
Abstract
OBJECTIVE: Depression and alcohol use disorder are among the most common causes of disability and death worldwide. Health care systems are seeking ways to leverage technology to screen, evaluate, and treat these conditions, because workforce interventions alone, particularly in low- and middle-income countries, are insufficient. This article reports data from the first year of implementation of a technology-supported, systematic approach to identify and care for persons with these disorders in primary care in Colombia. METHODS: A care process that includes waiting room kiosks to screen primary care patients, decision support tablets to guide doctors in diagnosis and treatment, and access to digital therapeutics as a treatment option was implemented in two primary care clinics, one urban and one in a small town. The project collected data on the number of people screened, diagnosed, and engaged in the research and their demographic characteristics. RESULTS: In the first year, 2,656 individuals were screened for depression and unhealthy alcohol use in the two clinics. Primary care doctors increased the percentage of patients diagnosed as having depression and alcohol use disorder from next to 0% to 17% and 2%, respectively. CONCLUSIONS: Early experience with implementing technology-supported screening and decision support for depression and alcohol use disorder into the workflow of busy primary care clinics in Colombia indicates that this care model is feasible and leads to dramatically higher rates of diagnoses of these conditions. Diagnosis in these settings appeared to be easier for depression than for alcohol use disorder.
OBJECTIVE:Depression and alcohol use disorder are among the most common causes of disability and death worldwide. Health care systems are seeking ways to leverage technology to screen, evaluate, and treat these conditions, because workforce interventions alone, particularly in low- and middle-income countries, are insufficient. This article reports data from the first year of implementation of a technology-supported, systematic approach to identify and care for persons with these disorders in primary care in Colombia. METHODS: A care process that includes waiting room kiosks to screen primary care patients, decision support tablets to guide doctors in diagnosis and treatment, and access to digital therapeutics as a treatment option was implemented in two primary care clinics, one urban and one in a small town. The project collected data on the number of people screened, diagnosed, and engaged in the research and their demographic characteristics. RESULTS: In the first year, 2,656 individuals were screened for depression and unhealthy alcohol use in the two clinics. Primary care doctors increased the percentage of patients diagnosed as having depression and alcohol use disorder from next to 0% to 17% and 2%, respectively. CONCLUSIONS: Early experience with implementing technology-supported screening and decision support for depression and alcohol use disorder into the workflow of busy primary care clinics in Colombia indicates that this care model is feasible and leads to dramatically higher rates of diagnoses of these conditions. Diagnosis in these settings appeared to be easier for depression than for alcohol use disorder.
Entities:
Keywords:
Alcohol/alcoholism; Depression; digital therapeutics; integrated care; primary care; screening
Authors: R L Spitzer; J B Williams; K Kroenke; M Linzer; F V deGruy; S R Hahn; D Brody; J G Johnson Journal: JAMA Date: 1994-12-14 Impact factor: 56.272
Authors: Jennifer F Bobb; Amy K Lee; Gwen T Lapham; Malia Oliver; Evette Ludman; Carol Achtmeyer; Rebecca Parrish; Ryan M Caldeiro; Paula Lozano; Julie E Richards; Katharine A Bradley Journal: Int J Environ Res Public Health Date: 2017-09-08 Impact factor: 3.390
Authors: Emily A Scherer; Stephen A Metcalf; Cady L Whicker; Sophia M Bartels; Michael Grabinski; Sunny Jung Kim; Mary Ann Sweeney; Shea M Lemley; Hannah Lavoie; Haiyi Xie; Patrick G Bissett; Jesse Dallery; Michaela Kiernan; Michael R Lowe; Lisa Onken; Judith J Prochaska; Luke E Stoeckel; Russell A Poldrack; David P MacKinnon; Lisa A Marsch Journal: Front Digit Health Date: 2022-03-18
Authors: C L Shannon; S M Bartels; M Cepeda; S Castro; L Cubillos; F Suárez-Obando; M J Williams; C Gómez Restrepo; M Uribe; L Marsch; W C Torrey Journal: Community Ment Health J Date: 2021-03-04
Authors: Arturo Marroquin Rivera; Juan Camilo Rosas-Romero; Sergio Mario Castro; Fernando Suárez-Obando; Jeny Aguilera-Cruz; Sophia Marie Bartels; Sena Park; William Chandler Torrey; Carlos Gómez-Restrepo Journal: Rev Colomb Psiquiatr (Engl Ed) Date: 2021-07-10
Authors: Sarah E Lord; Aimee N C Campbell; Mary F Brunette; Leonardo Cubillos; Sophia M Bartels; William C Torrey; Ardis L Olson; Steven H Chapman; John A Batsis; Daniel Polsky; Edward V Nunes; Katherine M Seavey; Lisa A Marsch Journal: JMIR Ment Health Date: 2021-01-28
Authors: Lisa A Marsch; Carlos Gómez-Restrepo; Sophie M Bartels; Kathleen Bell; Pablo Martinez Camblor; Sergio Castro; Maria Paula Cárdenas Charry; Magda Cepeda; Leonardo Cubillos; Deepak John; Maria Paula Jassir; Shea M Lemley; Fernando Suárez-Obando; William C Torrey; José Miguel Uribe; Makeda J Williams Journal: Psychiatr Serv Date: 2021-08-04 Impact factor: 3.084
Authors: Sophia M Bartels; Paula Cardenas; José M Uribe-Restrepo; Leonardo Cubillos; William C Torrey; Sergio M Castro; Makeda J Williams; Diana Goretty Oviedo-Manrique; Carlos Gómez-Restrepo; Lisa A Marsch Journal: Rev Colomb Psiquiatr (Engl Ed) Date: 2021-07-17
Authors: John A Naslund; Jasmine Kalha; Juliana L Restivo; Ishmael Amarreh; Tamora Callands; Hongtu Chen; Carlos Gomez-Restrepo; Hesham M Hamoda; Arjun Kapoor; Sue Levkoff; Jones Masiye; Maria A Oquendo; Vikram Patel; Inge Petersen; Ozge Sensoy Bahar; Laura Shields-Zeeman; Fred M Ssewamala; Deepak Tugnawat; José Miguel Uribe-Restrepo; Lakshmi Vijayakumar; Bradley H Wagenaar; Milton L Wainberg; Larry Wissow; Haja Ramatulai Wurie; Chifundo Zimba; Soumitra Pathare Journal: Asian J Psychiatr Date: 2021-01-24
Authors: Atif Rahman; John A Naslund; Theresa S Betancourt; Candace J Black; Anant Bhan; William Byansi; Hongtu Chen; Bradley N Gaynes; Carlos Gomez Restrepo; Lídia Gouveia; Syed Usman Hamdani; Lisa A Marsch; Inge Petersen; Ozge Sensoy Bahar; Laura Shields-Zeeman; Fred Ssewamala; Milton L Wainberg Journal: Lancet Psychiatry Date: 2020-08-23 Impact factor: 77.056