National Healthcare Quality and Disparities Report
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Topics
- Access to Care (1)
- Adverse Drug Events (ADE) (2)
- Adverse Events (2)
- Ambulatory Care and Surgery (1)
- Anxiety (4)
- Behavioral Health (27)
- Cancer (2)
- Cancer: Prostate Cancer (1)
- Cardiovascular Conditions (3)
- Children/Adolescents (4)
- Chronic Conditions (3)
- Comparative Effectiveness (3)
- (-) Depression (29)
- Diagnostic Safety and Quality (6)
- Disparities (2)
- Elderly (5)
- Electronic Health Records (EHRs) (1)
- Evidence-Based Practice (4)
- Genetics (1)
- Healthcare Costs (1)
- Healthcare Utilization (1)
- Health Information Technology (HIT) (2)
- Health Insurance (1)
- Health Services Research (HSR) (1)
- Heart Disease and Health (2)
- Hospitalization (1)
- Human Immunodeficiency Virus (HIV) (2)
- Implementation (3)
- Labor and Delivery (1)
- Long-Term Care (2)
- Low-Income (3)
- Maternal Care (1)
- Medicare (2)
- Medication (6)
- Men's Health (1)
- Mortality (1)
- Neurological Disorders (2)
- Nursing Homes (2)
- Obesity (1)
- Obesity: Weight Management (1)
- Outcomes (3)
- Patient-Centered Outcomes Research (6)
- Patient Adherence/Compliance (3)
- Patient and Family Engagement (1)
- Patient Safety (1)
- Pregnancy (2)
- Primary Care (3)
- Quality Improvement (1)
- Quality Measures (1)
- Quality of Care (2)
- Quality of Life (1)
- Racial and Ethnic Minorities (1)
- Registries (1)
- Research Methodologies (2)
- Respiratory Conditions (1)
- Risk (2)
- Screening (5)
- Sex Factors (1)
- Social Determinants of Health (3)
- Stress (1)
- Surgery (1)
- Trauma (1)
- Treatments (3)
- Women (4)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 29 Research Studies DisplayedBobo WV, Ryu E, Petterson TM
Bi-directional association between depression and HF: an electronic health records-based cohort study.
This study examined whether heart failure (HF) patients were more likely to be diagnosed with depression, or patients with depression were more likely to be diagnosed with HF. This retrospective cohort study utilized electronic health records (EHRs) from a large healthcare system in 2006 for adults who received primary care services. The EHR identified 10,649 people with depression, and 5,911 people with HF between 2006 to 2018. In the depression cohort there were 2,024 newly diagnosed occurrences of HF, and 944 occurrences of newly diagnosed depression in the HF cohort over 4-6 years of follow-up. There was a significantly higher risk of developing HF in the depression cohort than vice versa.
AHRQ-funded; HS023077.
Citation: Bobo WV, Ryu E, Petterson TM .
Bi-directional association between depression and HF: an electronic health records-based cohort study.
J Comorb 2020 Jan-Dec;10:2235042x20984059. doi: 10.1177/2235042x20984059..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Depression, Electronic Health Records (EHRs), Health Information Technology (HIT), Chronic Conditions
Liu FF, Lew A, Andes E
Implementation strategies for depression and anxiety screening in a pediatric cystic fibrosis center: a quality improvement project.
The objective of this study was to share key strategies that led to successful mental health screening (MHS) implementation in one pediatric cystic fibrosis center and to report implementation and screening outcomes. Results showed that leveraging coproduction to address stakeholder needs led to successful implementation of a sustainable MHS process.
AHRQ-funded; HS026393.
Citation: Liu FF, Lew A, Andes E .
Implementation strategies for depression and anxiety screening in a pediatric cystic fibrosis center: a quality improvement project.
Pediatr Pulmonol 2020 Dec;55(12):3328-36. doi: 10.1002/ppul.24951..
Keywords: Children/Adolescents, Respiratory Conditions, Chronic Conditions, Depression, Anxiety, Behavioral Health, Screening, Implementation, Quality Improvement, Quality of Care, Diagnostic Safety and Quality
Radovic A, Odenthal K, Flores AT
Prescribing technology to increase uptake of depression treatment in primary care: a pre-implementation focus group study of SOVA (Supporting Our Valued Adolescents).
Supporting Our Valued Adolescents (SOVA) is a web-based technology intervention designed to increase depression and anxiety treatment uptake by adolescents in the context of an anonymous peer community with an accompanying website for parents. With a goal of informing the design of a hybrid effectiveness-implementation randomized controlled trial, we conducted a pre-implementation study in two primary care practices to guide implementation strategy development. We conducted focus groups with primary care providers (PCPs) at three different timepoints with PCPs (14 total) from two community practices.
AHRQ-funded; HS022989.
Citation: Radovic A, Odenthal K, Flores AT .
Prescribing technology to increase uptake of depression treatment in primary care: a pre-implementation focus group study of SOVA (Supporting Our Valued Adolescents).
J Clin Psychol Med Settings 2020 Dec;27(4):766-82. doi: 10.1007/s10880-019-09669-5.
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Keywords: Children/Adolescents, Depression, Anxiety, Behavioral Health, Primary Care, Health Information Technology (HIT), Implementation
Guglielminotti J, Li G
Exposure to general anesthesia for cesarean delivery and odds of severe postpartum depression requiring hospitalization.
This retrospective cohort study evaluated the risk of general anesthesia use in cesarean delivery versus neuraxial anesthesia on maternal mental health. Cesarean deliveries performed in New York State hospitals between 2006 and 2013 were included. Exclusion criteria included having more than 1 cesarean delivery during the study period, residing outside of New York State, and having a general anesthetic for other surgery or delivery in the year before or after the index case. The primary outcome looked at was severe postpartum depression (PPD), and secondary outcomes were suicidal ideation, anxiety disorders, and posttraumatic stress disorder (PTSD). The majority of cesareans used neuraxial anesthesia and only 8% (34,356) had general anesthesia. Severe PPD requiring hospitalization occurred in 1158 women with 60% identified during readmission. General anesthesia was found to be associated with a 54% increased odds of PPD, and a 91% increased odds of suicidal ideation or self-inflicted injury. There was insufficient evidence for increased risk of anxiety orders.
AHRQ-funded; HS025787.
Citation: Guglielminotti J, Li G .
Exposure to general anesthesia for cesarean delivery and odds of severe postpartum depression requiring hospitalization.
Anesth Analg 2020 Nov;131(5):1421-29. doi: 10.1213/ane.0000000000004663..
Keywords: Labor and Delivery, Pregnancy, Women, Depression, Behavioral Health, Surgery, Risk, Hospitalization, Medication, Adverse Drug Events (ADE), Adverse Events
Orth J, Li Y, Simning A
Severe behavioral health manifestations in nursing homes: associations with service availability?
The objective of this study was to examine associations between availability of behavioral health (BH) services and the presence of severe depression, suicidal ideation (SI), and severe aggressive behaviors (ABs) among nursing home (NH) residents. 2017 survey data on BH service availability was obtained from 1,051 NHs and the Minimum Data Set (MDS) to identify long-term stay residents in these facilities (n = 101,238). Odds of severe depression were 21% higher when NHs reported inadequate BH staff education as well as 13% higher for SI and 10% higher for severe ABs among residents in facilities reporting inadequate facility infrastructure. Facility-level factors such as staffing, training, and turnover were also statistically significant associations with these severe BH manifestations.
AHRQ-funded; HS024923.
Citation: Orth J, Li Y, Simning A .
Severe behavioral health manifestations in nursing homes: associations with service availability?
J Am Geriatr Soc 2020 Nov;68(11):2643-49. doi: 10.1111/jgs.16772..
Keywords: Elderly, Nursing Homes, Long-Term Care, Depression, Behavioral Health, Access to Care
Fung V, Price M, Nierenberg AA
Assessment of behavioral health services use among low-income Medicare beneficiaries after reductions in coinsurance fees.
This study looked at outcomes from reducing behavioral health care Medicare coinsurance from 50% to 20% from 2009 to 2013. The sample of patients looked at included some diagnosed with SMI (serious mental illness) including schizophrenia, bipolar, or major depressive disorder). Data analysis was performed on 793,275 beneficiaries with SMI in 2008 and compared them with costs in 2013. The mean adjusted out-of-pocket costs for outpatient behavioral care decreased from $132 annually to $64, but the number of visits only increased slightly. No association was found between cost-sharing reductions and changes in behavioral health care visits.
AHRQ-funded; HS024725.
Citation: Fung V, Price M, Nierenberg AA .
Assessment of behavioral health services use among low-income Medicare beneficiaries after reductions in coinsurance fees.
JAMA Netw Open 2020 Oct;3(10):e2019854. doi: 10.1001/jamanetworkopen.2020.19854..
Keywords: Medicare, Health Insurance, Depression, Behavioral Health, Low-Income, Healthcare Costs, Healthcare Utilization
Katon JG, Callegari LS, Bossick AS
Association of depression and post-traumatic stress disorder with receipt of minimally invasive hysterectomy for uterine fibroids: findings from the U.S. Department of Veterans Affairs.
Researchers sought to examine whether depression and PTSD are associated with minimally invasive hysterectomy (MIH). Studying veterans with uterine fibroids undergoing hysterectomy in the Department of Veterans Affairs between 2012 and 2014, they found that veterans with depression or PTSD were more likely that those without to have a MIH, possibly owing to smaller uterine size, suggesting that they may be undergoing hysterectomy earlier in the disease process. They recommended further research to understand whether this reflects high-quality, patient-centered care.
AHRQ-funded; HS013853.
Citation: Katon JG, Callegari LS, Bossick AS .
Association of depression and post-traumatic stress disorder with receipt of minimally invasive hysterectomy for uterine fibroids: findings from the U.S. Department of Veterans Affairs.
Womens Health Issues 2020 Sep-Oct;30(5):359-65. doi: 10.1016/j.whi.2020.06.005..
Keywords: Depression, Behavioral Health, Women
Baik D, Liu J, Cho H
Factors related to biological sex differences in engagement with healthcare providers in persons living with HIV.
Investigators conducted a secondary analysis of data collected from four projects focused on improving health outcomes in persons living with HIV (PLWH). They found that male patients displayed negative association between depression and engagement with healthcare providers and positive association between engagement with healthcare providers and medication adherence, while female patients showed no association between any of these factors. Anxiety and stigma were not significantly associated with medication adherence. They concluded that adherence interventions for PLWH should be tailored by biological sex.
AHRQ-funded; HS025071.
Citation: Baik D, Liu J, Cho H .
Factors related to biological sex differences in engagement with healthcare providers in persons living with HIV.
AIDS Behav 2020 Sep;24(9):2656-65. doi: 10.1007/s10461-020-02823-3..
Keywords: Human Immunodeficiency Virus (HIV), Sex Factors, Patient and Family Engagement, Patient Adherence/Compliance, Depression, Behavioral Health, Medication
Bolstad CJ, Moak R, Brown CJ
Neighborhood disadvantage is associated with depressive symptoms but not depression diagnosis in older adults.
This study tested how neighborhood disadvantage (ND) relates to depressive symptomology and diagnosis to assess for neighborhood disparities in mental health care cross-sectionally. Using data from the University of Alabama at Birmingham Study of Aging, the investigators found living in the high and mid-ND tertiles to be associated with depressive symptomology, yet ND had no significant relation to depression diagnosis. They concluded that older adults living in high and mid-disadvantaged neighborhoods may be more likely to experience depressive symptomology but not receive a diagnosis, indicating a possible disparity in mental health care.
AHRQ-funded; HS013852.
Citation: Bolstad CJ, Moak R, Brown CJ .
Neighborhood disadvantage is associated with depressive symptoms but not depression diagnosis in older adults.
Int J Environ Res Public Health 2020 Aug 8;17(16). doi: 10.3390/ijerph17165745..
Keywords: Elderly, Depression, Behavioral Health, Diagnostic Safety and Quality, Disparities, Social Determinants of Health
Darling KE, Ranzenhofer LM, Hadley W
Negative childhood experiences and disordered eating in adolescents in a weight management program: the role of depressive symptoms.
This cross-sectional study examined the association between stressful life events and weight-related outcomes including weight status, disordered eating behaviors, and insulin sensitivity in treatment-seeking adolescents with overweight and obesity. The authors were also looking at the potential mediating role of depression. The study included 170 adolescents (mean age 14.8, 62% female) enrolled in an interdisciplinary weight management program. Findings were that stressful childhood experiences were significantly related to weight status and disordered eating but not insulin sensitivity. Depressive symptoms were related to stressful experiences and disordered eating patterns but not weight status or insulin sensitivity.
AHRQ-funded; HS027071.
Citation: Darling KE, Ranzenhofer LM, Hadley W .
Negative childhood experiences and disordered eating in adolescents in a weight management program: the role of depressive symptoms.
Eat Behav 2020 Aug;38:101402. doi: 10.1016/j.eatbeh.2020.101402..
Keywords: Children/Adolescents, Obesity: Weight Management, Obesity, Stress, Depression, Behavioral Health, Trauma
Rhee TG, Olfson M, Sint K
Characterization of the quality of electroconvulsive therapy among older Medicare beneficiaries.
Electroconvulsive therapy (ECT) is an important therapy for treatment-resistant depression and is especially effective for elderly individuals with depression. This study provides the first US nationally representative description of ECT in the elderly. The investigators concluded that despite substantial evidence of efficacy, ECT use remained rare among elderly patients with depression.
AHRQ-funded; HS023000.
Citation: Rhee TG, Olfson M, Sint K .
Characterization of the quality of electroconvulsive therapy among older Medicare beneficiaries.
J Clin Psychiatry 2020 Jul 7;81(4). doi: 10.4088/JCP.19m13186.
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Keywords: Elderly, Medicare, Depression, Behavioral Health, Treatments, Patient-Centered Outcomes Research
Gliklich RE, Leavy MB, Cosgrove L
AHRQ Author: Berliner E
Harmonized outcome measures for use in depression patient registries and clinical practice.
This project’s goal was to develop a minimum set of standardized outcome measures relevant to both patients and clinicians that can be collected in depression registries and clinical practice. A multi-stakeholder panel categorized the 27 identified measures using AHRQ's supported Outcome Measures Framework. The panel then identified 10 broadly relevant measures and harmonized definitions for these measures. These harmonized measures represent a minimum set of outcomes that are relevant to clinicians and patients and appropriate for use in depression research and clinical practice.
AHRQ-authored; AHRQ-funded; 290201400004C.
Citation: Gliklich RE, Leavy MB, Cosgrove L .
Harmonized outcome measures for use in depression patient registries and clinical practice.
Ann Intern Med 2020 Jun 16;172(12):803-09. doi: 10.7326/m19-3818..
Keywords: Registries, Depression, Behavioral Health, Outcomes, Patient-Centered Outcomes Research
Erim DO, Bennett AV, Gaynes BN
Associations between prostate cancer-related anxiety and health-related quality of life.
This study followed prostate cancer patients who were enrolled in the cohort study North Cancer Prostate Cancer Comparative Effectiveness & Survivorship Study (NC ProCess) from January 2011 and June 2013. A 1-year follow-up survey was done to assess prostate cancer-related anxiety (PCRA) in the cohort. The researchers were interested in the association between PCRA and health-related quality of life (HRQOL). The risk of probable depression was significantly higher in participants with clinically significant PCRA compared with those without it.
AHRQ-funded; 29020050040I.
Citation: Erim DO, Bennett AV, Gaynes BN .
Associations between prostate cancer-related anxiety and health-related quality of life.
Cancer Med 2020 Jun;9(12):4467-73. doi: 10.1002/cam4.3069..
Keywords: Cancer: Prostate Cancer, Cancer, Anxiety, Quality of Life, Men's Health, Patient-Centered Outcomes Research, Depression, Evidence-Based Practice
Davoudian PA, Wilkinson ST
Clinical overview of NMDA-R antagonists and clinical practice.
This study examines the promise of new therapies for treatment of depression, which is only treatable about half the time with medication. Recent research has found that therapies that target the glutamatergic system, especially NMDA receptor antagonists have shown efficacy in several clinical trials. The authors specifically discuss treatment using ketamine as well as other newer compounds that have also shown recent promise in clinical trials.
AHRQ-funded; HS023000.
Citation: Davoudian PA, Wilkinson ST .
Clinical overview of NMDA-R antagonists and clinical practice.
Adv Pharmacol 2020;89:103-29. doi: 10.1016/bs.apha.2020.04.004..
Keywords: Medication, Depression, Behavioral Health, Treatments
Jannat-Khah DP, Khodneva Y, Bryant K
Depressive symptoms do not discriminate: racial and economic influences between time-varying depressive symptoms and mortality among REGARDS participants.
This study examined whether time-varying depressive symptoms (TVDS) predict mortality and if racial and income differences moderate the association in a large cohort. The cohort from the REGARDS study was used to look at that determination. The REGARDS study used community-dwelling U.S. adults aged 45 years or older. They found that there was similar and statistically significant differences with white, black, and low-income ($35,000 or less) participants for the association between TVDS and mortality. High-income participants were found to have a lower hazard.
AHRQ-funded; HS025198.
Citation: Jannat-Khah DP, Khodneva Y, Bryant K .
Depressive symptoms do not discriminate: racial and economic influences between time-varying depressive symptoms and mortality among REGARDS participants.
Ann Epidemiol 2020 Jun;46:31-40.e2. doi: 10.1016/j.annepidem.2020.04.004..
Keywords: Depression, Behavioral Health, Racial and Ethnic Minorities, Cardiovascular Conditions, Cancer, Low-Income, Social Determinants of Health, Mortality
Wu Y, Levis B, Riehm KE
Equivalency of the diagnostic accuracy of the PHQ-8 and PHQ-9: a systematic review and individual participant data meta-analysis.
Item 9 of the Patient Health Questionnaire-9 (PHQ-9) queries about thoughts of death and self-harm, but not suicidality. Although it is sometimes used to assess suicide risk, most positive responses are not associated with suicidality. The PHQ-8, which omits Item 9, is thus increasingly used in research. In this study the investigators assessed equivalency of total score correlations and the diagnostic accuracy to detect major depression of the PHQ-8 and PHQ-9.
AHRQ-funded; HS018246.
Citation: Wu Y, Levis B, Riehm KE .
Equivalency of the diagnostic accuracy of the PHQ-8 and PHQ-9: a systematic review and individual participant data meta-analysis.
Psychol Med 2020 Jun;50(8):1368-80. doi: 10.1017/s0033291719001314..
Keywords: Diagnostic Safety and Quality, Depression, Behavioral Health, Screening
Moise N, Thanataveerat A, Florez-Salamanca L
Willingness to engage in traditional and novel depression treatment modalities among myocardial infarction survivors.
The authors assessed depression treatment attitudes, acceptability, and willingness by modality among myocardial infarction survivors with elevated depressive symptoms. They found that, despite positive attitudes and general willingness, only 20% were currently in therapy, perhaps due to suboptimal guideline implementation/symptom recognition, low motivation, and access/cost. Additionally, interest in self-help apps was low. The authors recommend further study to understand gaps between generally positive treatment attitudes and low treatment initiation rates.
AHRQ-funded; HS025198.
Citation: Moise N, Thanataveerat A, Florez-Salamanca L .
Willingness to engage in traditional and novel depression treatment modalities among myocardial infarction survivors.
J Gen Intern Med 2020 May;35(5):1620-22. doi: 10.1007/s11606-019-05406-8..
Keywords: Depression, Behavioral Health, Heart Disease and Health, Cardiovascular Conditions, Patient Adherence/Compliance
Katz D, Petersen T, Amado S
An evaluation of suicidal risk in bipolar patients with comorbid posttraumatic stress disorder.
The impact of concurrent diagnosis posttraumatic stress disorder (PTSD) on persons with bipolar disorder (BD) was analyzed to determine if there was a higher risk of suicidal ideation. Baseline data from the 482 individuals enrolled in the Clinical and Health Outcomes Initiative in Comparative Effectiveness for bipolar disorder study (Bipolar CHOICE) was used. The association of comorbid PTSD with increased suicidal ideation was assessed by the Concise Health Risk Tracking Scale (CHRT) total and factor scores. As the authors hypothesized, diagnosis of comorbid PTSD was a significant predictor of the CHRT total score. All participants with comorbid PTSD (n=58) endorsed current suicidal ideation and were more likely to have had a previous suicide attempt compared to those without PTSD.
AHRQ-funded; HS019371.
Citation: Katz D, Petersen T, Amado S .
An evaluation of suicidal risk in bipolar patients with comorbid posttraumatic stress disorder.
J Affect Disord 2020 Apr 1;266:49-56. doi: 10.1016/j.jad.2020.01.091..
Keywords: Behavioral Health, Risk, Evidence-Based Practice, Comparative Effectiveness, Patient-Centered Outcomes Research, Depression
Crockett KB, Entler KJ, Brodie E
Brief report: linking depressive symptoms to viral nonsuppression among women with HIV through adherence self-efficacy and ART adherence.
The authors examined a longitudinal sequential path model of the association between depressive symptoms and viral non-suppression in women with HIV (WWH) through adherence self-efficacy beliefs and antiretroviral treatment (ART) adherence behavior mechanisms. Their findings supported depressive symptoms' association with adherence self-efficacy that in turn lead to suboptimal ART adherence and ultimately to viral non-suppression for WWH. They recommended tailoring of interventions aimed at addressing depressive symptoms, substance use, and adherence self-efficacy among WWH to help close the gap between ART prescription and viral suppression on the HIV care continuum.
AHRQ-funded; HS013852.
Citation: Crockett KB, Entler KJ, Brodie E .
Brief report: linking depressive symptoms to viral nonsuppression among women with HIV through adherence self-efficacy and ART adherence.
J Acquir Immune Defic Syndr 2020 Apr;83(4):340-44. doi: 10.1097/qai.0000000000002268..
Keywords: Human Immunodeficiency Virus (HIV), Depression, Behavioral Health, Women, Patient Adherence/Compliance
Coley RY, Boggs JM, Beck A
Defining success in measurement-based care for depression: a comparison of common metrics.
This study compared response and remission measures with effect size and severity-adjusted effect size (SAES) measures and examined the relationship between baseline symptom severity and treatment success for depression. Electronic records from two large integrated health systems were used to identify new psychotherapy episodes. Findings showed that response was preferable for comparing treatment outcomes, as it did not favor more or less baseline symptom severity, indicated clinically meaningful improvement, and was transparent and easy to calculate.
AHRQ-funded; HS026369.
Citation: Coley RY, Boggs JM, Beck A .
Defining success in measurement-based care for depression: a comparison of common metrics.
Psychiatr Serv 2020 Apr;71(4):312-18. doi: 10.1176/appi.ps.201900295..
Keywords: Depression, Behavioral Health, Patient-Centered Outcomes Research, Outcomes, Quality of Care, Quality Measures
Chatterjee S, Bali V, Carnahan RM
Anticholinergic burden and risk of cognitive impairment in elderly nursing home residents with depression.
This study evaluated whether elderly nursing home residents with mild depression and intact cognition experienced cognitive impairment after using anticholinergic drugs. The study was a population-based nested case-control study using Minimum Data Set (MDS)-linked Medicare data where the base cohort were patients 65 years and older with depression who had intact cognition. Cumulative anticholinergic burden was measured within 30, 60, and 90 days preceding the event (cognitive measurement) date using the Anticholinergic Drug Scale (ADS). The end sample compared 3707 cases with mild-to-moderate cognition to 3707 matched controls with intact cognition. There was no association with cumulative anticholinergic exposure at 30 days with cognitive impairment, but the odds of cognitive impairment increased with exposure 60 and 90 days before the event date. This study concludes there should be concern in using anticholinergic drugs for longer than 30 days with elderly nursing home residents.
AHRQ-funded; HS021264.
Citation: Chatterjee S, Bali V, Carnahan RM .
Anticholinergic burden and risk of cognitive impairment in elderly nursing home residents with depression.
Res Social Adm Pharm 2020 Mar;16(3):329-35. doi: 10.1016/j.sapharm.2019.05.020..
Keywords: Elderly, Nursing Homes, Long-Term Care, Depression, Behavioral Health, Medication, Neurological Disorders, Adverse Drug Events (ADE), Adverse Events, Patient Safety
Munger Clary HM, Croxton RD, Allan J
Who is willing to participate in research? A screening model for an anxiety and depression trial in the epilepsy clinic.
This study assessed the willingness of epilepsy patients positively screened for anxiety and/or depression to participate in a research study. A total of 199 patients screened positively during a routine epilepsy screening visit and 154 (77.4%) opted-in for further research assessment. Nearly half of those 199 individuals were already being treated for anxiety and/or depression, with 46.7% receiving neither antidepressants or therapy. Higher depression scores and current treatment were independently associated with opting in. One-quarter reported a past psychiatric hospitalization, but only half of those individuals were currently receiving mental health specialty care.
AHRQ-funded; HS025723.
Citation: Munger Clary HM, Croxton RD, Allan J .
Who is willing to participate in research? A screening model for an anxiety and depression trial in the epilepsy clinic.
Epilepsy Behav 2020 Mar;104(Pt A):106907. doi: 10.1016/j.yebeh.2020.106907..
Keywords: Anxiety, Depression, Behavioral Health, Neurological Disorders, Chronic Conditions, Screening, Diagnostic Safety and Quality, Health Services Research (HSR), Research Methodologies
Gaynes BN, Lux L, Gartlehner G
Defining treatment-resistant depression.
The authors conducted a review for the Centers for Medicare & Medicaid Services and AHRQ to clarify how experts and investigators have defined treatment-resistant depression (TRD) and to review systematically how well this definition comports with TRD definitions in clinical trials through July 5, 2019. They found that no consensus definition existed for TRD. While depressive outcomes and clinical global impressions were commonly measured, functional impairment and quality-of-life tools were rarely used. They recommend stronger approaches to designing and conducting TRD research in order to foster better evidence to translate into clearer guidelines for treating patients with TRD.
AHRQ-funded; 290201500011I.
Citation: Gaynes BN, Lux L, Gartlehner G .
Defining treatment-resistant depression.
Depress Anxiety 2020 Feb;37(2):134-45. doi: 10.1002/da.22968..
Keywords: Depression, Behavioral Health, Evidence-Based Practice, Implementation, Research Methodologies
Ochs-Ross R, Daly EJ, Zhang Y
Efficacy and safety of esketamine nasal spray plus an oral antidepressant in elderly patients with treatment-resistant depression-TRANSFORM-3.
This phase 3 double-blind study randomized patients with treatment-resistant depression age 65 or older to flexibly-dosed esketamine nasal spray and new oral antidepressant (esketamine/antidepressant) or new oral antidepressant and placebo nasal spray (antidepressant/placebo). The primary endpoint was change in the Montgomery-Asberg Depression Rating Scale (MADRS) over 28 days from baseline. Results showed that esketamine/antidepressant did not achieve statistical significance for patients ages 75 and older; however, greater differences were seen for patients ages 65-74 and patients with earlier onset of depression younger than age 55.
AHRQ-funded; HS023000.
Citation: Ochs-Ross R, Daly EJ, Zhang Y .
Efficacy and safety of esketamine nasal spray plus an oral antidepressant in elderly patients with treatment-resistant depression-TRANSFORM-3.
Am J Geriatr Psychiatry 2020 Feb;28(2):121-41. doi: 10.1016/j.jagp.2019.10.008..
Keywords: Medication, Depression, Behavioral Health, Elderly, Comparative Effectiveness, Treatments, Evidence-Based Practice
Ruaño Ruaño, Robinson S, Holford T
Results of the CYP-GUIDES randomized controlled trial: total cohort and primary endpoints.
CYP-GUIDES (Cytochrome Psychotropic Genotyping Under Investigation for Decision Support) was a randomized controlled trial (RCT) comparing 2 outcomes in hospitalized patients with major depressive disorder (MDD) treated according to the patient's CYP2D6 genotype and functional status versus standard psychotropic therapy. This paper describes the results of that study. The primary outcome was hospital Length of Stay (LOS) and the secondary outcome was the Re-Admission Rate (RAR) 30 days after discharge.
AHRQ-funded; HS022304.
Citation: Ruaño Ruaño, Robinson S, Holford T .
Results of the CYP-GUIDES randomized controlled trial: total cohort and primary endpoints.
Contemp Clin Trials 2020 Feb;89:105910. doi: 10.1016/j.cct.2019.105910..
Keywords: Depression, Behavioral Health, Genetics, Medication