Empowering Primary Care Providers to Combat Depression in Their Practice

MANHATTAN, N.Y. - Jan. 10, 2020 - PRLog -- DKBmed, LLC, University of Kentucky (UK) HealthCare CECentral, and the Postgraduate Institute for Medicine have partnered to create a new quality improvement (QI) program designed to enhance the knowledge about screening for major depressive disorder (MDD), Derail Depression UK (www.cecentral.com/MDD). MDD causes over 400 million disabling days per year. For many patients, MDD is accompanied by low rates of treatment adherence, incomplete or delayed response to treatment, adverse events, and less than optimal selection of pharmacotherapy. The problem is exacerbated in rural America where residents face more obstacles to treatment including staffing shortages, accessibility (distance, knowledge), acceptability (negative perception and stigma), and affordability.

Symptoms of MDD are often easy to misdiagnose and undertreat in the primary care setting where most patients present. In Kentucky, fewer than 35% of patients are currently being screened for MDD. Most PCPs do not use measurement-based care through depression-monitoring tools (eg, PHQ-9), limiting their ability to monitor whether first-line therapies are successfully managing patients' MDD and preventing their recognition of when adjunctive therapy and/or specialist care (behavioral health or psychiatric) are necessary.

"Primary care providers need appropriate guidance from psychiatry/behavioral health specialists when patients' symptoms do not improve, and they must develop the skills to know when patients need psychiatric consultation," stated James D. Hawthorne III, MD, Assistant Professor of Psychiatry at University of Kentucky. "The lack of accessible psychiatry/behavioral health specialists exacerbates this problem in rural areas. Patients and clinicians alike would benefit from a more collaborative style and measurement-based approach to MDD management."

Derail Depression UK will be deployed to all primary care clinicians and allied health providers at 10-15 rural practices throughout the central and eastern Kentucky regions. The program is a multiplatform approach designed to demonstrate actual practice change through:

• Encouraging regular use of the MDD clinician measurement tool (PHQ-9).
• Online educational program directed to Kentucky clinicians and affiliated staff.
• Telemedicine for psychiatry/behavioral health specialist outreach to clinicians and patients in rural areas.
• A daily measurement tool (patient portal/mobile app) that records patients' day-to-day mood fluctuations to supplement the PHQ-9 data.
• An algorithm within the EHR that alerts primary care clinicians when patients' MDD is not improving based on PHQ-9 and patient data.
• A built-in referral network to behavioral health specialists for patients requiring additional care.