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Search All Research Studies
Topics
- Ambulatory Care and Surgery (1)
- Anxiety (2)
- Behavioral Health (19)
- Cancer (1)
- Care Coordination (1)
- Caregiving (1)
- Care Management (1)
- Children/Adolescents (8)
- Chronic Conditions (3)
- Clinical Decision Support (CDS) (1)
- Comparative Effectiveness (1)
- (-) Depression (24)
- Diagnostic Safety and Quality (4)
- Elderly (2)
- Electronic Health Records (EHRs) (1)
- Evidence-Based Practice (1)
- Guidelines (1)
- Healthcare Delivery (1)
- Health Information Technology (HIT) (4)
- Implementation (1)
- Medicare (1)
- Mortality (1)
- Patient-Centered Healthcare (5)
- Patient-Centered Outcomes Research (1)
- Patient and Family Engagement (1)
- Prevention (1)
- (-) Primary Care (24)
- Primary Care: Models of Care (2)
- Racial and Ethnic Minorities (2)
- Screening (10)
- Shared Decision Making (3)
- Substance Abuse (1)
- Tobacco Use (1)
- Treatments (2)
- U.S. Preventive Services Task Force (USPSTF) (1)
- Women (1)
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 24 of 24 Research Studies DisplayedMoise N, Paniagua-Avila A, Barbecho JM
A theory-informed, rapid cycle approach to identifying and adapting strategies to promote sustainability: optimizing depression treatment in primary care clinics seeking to sustain collaborative care (the transform depcare study).
This study used a collaborative care (CC) use case to describe a novel, theory-informed, stakeholder engaged process for operationalizing strategies for sustainability using a behavioral lens. The goal is to optimize depression treatment in primary care clinics using the Transform DepCare shared decision-making and psychoeducation patient tool. The authors applied the Behaviour Change Wheel to their prior mixed methods to identify key sustainability behaviors and determinants of sustainability. The authors enlisted 22 national and local stakeholders to operationalize and adapt a multi-level, multi-component implementation strategy to maximally target behavioral and contextual determinants of sustainability. They identified ongoing care manager CC delivery, provider treatment optimization, and patient enrollment as key sustainability behaviors. They determined that a waiting room that delivered DepCare, the results of which are delivered to providers, as well as ongoing problem-solving meetings/local technical assistance with care managers would be the most acceptable and equitable multi-level strategy in diverse settings seeking to sustain CC programs. Key improvements would include expanding the DepCare tool to incorporate anxiety/suicide screening, triage support, multi-modal delivery, and patient activation (vs. shared decision making) (patient); pairing summary reports with decisional support and yearly onboarding/motivational educational videos (provider); incorporating behavioral health providers into problem-solving meetings and shifting from billing support to quality improvement and triage (system).
AHRQ-funded; HS025198.
Citation: Moise N, Paniagua-Avila A, Barbecho JM .
A theory-informed, rapid cycle approach to identifying and adapting strategies to promote sustainability: optimizing depression treatment in primary care clinics seeking to sustain collaborative care (the transform depcare study).
Implement Sci Commun 2023 Jan 25; 4(1):10. doi: 10.1186/s43058-022-00383-2..
Keywords: Depression, Primary Care, Behavioral Health, Patient-Centered Healthcare, Patient-Centered Outcomes Research
Viswanathan M, Wallace IF, Cook Middleton J
Screening for depression and suicide risk in children and adolescents: updated evidence report and systematic review for the US Preventive Services Task Force.
The authors sought to review the evidence on screening for depression or suicide risk in children and adolescents to inform the US Preventive Services Task Force. They found indirect evidence that suggested some screening instruments were reasonably accurate for detecting depression. Further, psychotherapy and pharmacotherapy were associated with some benefits and no statistically significant harms for depression, but the evidence was limited for suicide risk screening instruments and interventions.
AHRQ-funded; 290201500011I.
Citation: Viswanathan M, Wallace IF, Cook Middleton J .
Screening for depression and suicide risk in children and adolescents: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2022 Oct 18;328(15):1543-56. doi: 10.1001/jama.2022.16310..
Keywords: U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Depression, Behavioral Health, Screening, Primary Care, Guidelines, Evidence-Based Practice, Prevention
Wright JH, Owen J, Eells TD
Effect of computer-assisted cognitive behavior therapy vs usual care on depression among adults in primary care: a randomized clinical trial.
Computer-assisted cognitive behavior therapy (CCBT) has been proposed as a method for improving access to effective psychotherapy, reducing cost, and increasing the convenience and efficiency of treatment for depression. The purpose of this study was to evaluate whether clinician-supported CCBT is more effective than treatment as usual (TAU) in primary care patients with depression and to examine the feasibility and implementation of CCBT in a primary care population with substantial numbers of patients with low income, limited internet access, and low levels of educational attainment.
AHRQ-funded; HS024047.
Citation: Wright JH, Owen J, Eells TD .
Effect of computer-assisted cognitive behavior therapy vs usual care on depression among adults in primary care: a randomized clinical trial.
JAMA Netw Open 2022 Feb;5(2):e2146716. doi: 10.1001/jamanetworkopen.2021.46716..
Keywords: Depression, Behavioral Health, Primary Care, Treatments, Comparative Effectiveness
Tobin JN, Cassells A, Weiss E
Integrating cancer screening and mental health services in primary care: protocol and baseline results of a patient-centered outcomes intervention study.
AHRQ-funded; HS021667.
Citation: Tobin JN, Cassells A, Weiss E .
Integrating cancer screening and mental health services in primary care: protocol and baseline results of a patient-centered outcomes intervention study.
J Health Care Poor Underserved 2021;32(4):1907-34. doi: 10.1353/hpu.2021.0173..
Keywords: Patient-Centered Healthcare, Cancer, Behavioral Health, Primary Care, Depression, Women, Screening
Chen H, Upadhyay N, Lyu N
Association of primary and behavioral health integrated care upon pediatric mental disorder treatment.
This study’s objective was to examine whether linkage with mental health (MH) treatment differed across 3 different integrated care agreements (ICAs) following diagnosis for Attention Deficit Hyperactive Disorder (ADHD) or Major Depressive Disorder (MDD) given by primary care providers (PCPs) in the pediatric setting. The ICAs were categorized as PCPs who practiced alone (non-co-located); PCPs practiced with specialist outside the practice but co-located at the practice site; and employed specialists who were co-located. A total of 4203 incident ADHD and 298 incident MDD diagnoses were identified, of which 74% of ADHD cases and 67% of MDD cases received treatment within 90 days of diagnosis. Children with ADHD were twice as likely to receive treatment if they were diagnosed by non-co-located or co-affiliated PCPs than those diagnosed by non-co-located PCPs. Those treated children were also 2 times more likely to receive guideline recommended psychotherapy and treated at the diagnosing site versus elsewhere.
AHRQ-funded; HS025251.
Citation: Chen H, Upadhyay N, Lyu N .
Association of primary and behavioral health integrated care upon pediatric mental disorder treatment.
Acad Pediatr 2021 Sep-Oct;21(7):1187-94. doi: 10.1016/j.acap.2021.05.021..
Keywords: Children/Adolescents, Behavioral Health, Patient-Centered Healthcare, Primary Care, Healthcare Delivery, Depression
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
Stafford AM, Garbuz T, Etter DJ
The natural course of adolescent depression treatment in the primary care setting.
Little is known about how adolescents receive depression follow-up in primary care. The purpose of this study was to describe the rates of symptom assessment and depression treatment over time in a group of adolescents screening positive for moderate or severe depression in the primary care setting. Retrospective chart reviews were conducted to gather information related to symptom reassessments, antidepressant prescriptions, psychotherapy referrals, and treatment discontinuation.
AHRQ-funded; HS022681.
Citation: Stafford AM, Garbuz T, Etter DJ .
The natural course of adolescent depression treatment in the primary care setting.
J Pediatr Health Care 2020 Jan-Feb;34(1):38-46. doi: 10.1016/j.pedhc.2019.07.002..
Keywords: Children/Adolescents, Depression, Behavioral Health, Primary Care
Samples H, Stuart EA, Saloner B
The role of screening in depression diagnosis and treatment in a representative sample of US primary care visits.
This study aimed to examine depression screening patterns and the role of screening in depression diagnosis and treatment in the outpatient primary care setting. The investigators found that physicians appeared to use depression screening selectively based on patients' presenting symptoms. Higher screening rates were associated with higher odds of depression diagnosis and treatment. The investigators suggest that even modest increases in screening rates could meaningfully increase population-level rates of depression identification and treatment in primary care.
AHRQ-funded; HS000029.
Citation: Samples H, Stuart EA, Saloner B .
The role of screening in depression diagnosis and treatment in a representative sample of US primary care visits.
J Gen Intern Med 2020 Jan;35(1):12-20. doi: 10.1007/s11606-019-05192-3..
Keywords: Depression, Behavioral Health, Diagnostic Safety and Quality, Primary Care, Screening, Ambulatory Care and Surgery
Sorkin DH, Rizzo S, Biegler K
AHRQ Author: Ngo-Metzger Q
Novel health information technology to aid provider recognition and treatment of major depressive disorder and posttraumatic stress disorder in primary care.
This article describes a multicomponent health information technology screening tool designed to aid provider recognition and treatment of major depressive disorder and posttraumatic stress disorder (PTSD) in the primary care setting, with an eye toward meeting the mental health needs of traumatized refugees in the US Cambodian community. In a randomized controlled trial, 18 primary care providers were randomized to receive access to the mental health screening intervention, or to a minimal intervention control group. Cambodian American patients empaneled to participating providers were assigned to the providers' randomized group. From the results, the authors conclude that this approach offers the potential for training providers to diagnose and treat traumatized patients seeking mental health care in primary care.
AHRQ-authored.
Citation: Sorkin DH, Rizzo S, Biegler K .
Novel health information technology to aid provider recognition and treatment of major depressive disorder and posttraumatic stress disorder in primary care.
Med Care 2019 Jun;57 Suppl 6 Suppl 2:S190-s96. doi: 10.1097/mlr.0000000000001036..
Keywords: Depression, Diagnostic Safety and Quality, Health Information Technology (HIT), Behavioral Health, Primary Care, Primary Care: Models of Care, Racial and Ethnic Minorities, Screening
Rinke ML, German M, Azera B
Effect of mental health screening and integrated mental health on adolescent depression-coded visits.
This article describes a retrospective primary care network natural cohort study to analyze how mental health screening and integrated mental health practitioners affect adolescent depression identification. The percentage of depression-coded adolescent visits were compared between practices with and without mental health screening and with and without integrated mental health practitioners, using difference-in-differences analyses. The authors conclude that adolescent mental health screening and integrated mental health practitioners increase depression-coded visits in primary care.
AHRQ-funded; HS0203608.
Citation: Rinke ML, German M, Azera B .
Effect of mental health screening and integrated mental health on adolescent depression-coded visits.
Clin Pediatr 2019 Apr;58(4):437-45. doi: 10.1177/0009922818821889..
Keywords: Children/Adolescents, Depression, Diagnostic Safety and Quality, Primary Care, Screening
Antle BF, Owen JJ, Eells TD
Dissemination of computer-assisted cognitive-behavior therapy for depression in primary care.
Computer-assisted cognitive-behavior therapy (CCBT) for depression in primary care was evaluated in a trial with 240 patients randomly assigned to CCBT or treatment as usual (TAU). The study, described in this paper, disseminated a therapy method found to be effective in psychiatric settings into primary care - a setting in which there have been significant problems in the delivery of adequate, evidence-based treatment for depression.
AHRQ-funded; HS024047.
Citation: Antle BF, Owen JJ, Eells TD .
Dissemination of computer-assisted cognitive-behavior therapy for depression in primary care.
Contemp Clin Trials 2019 Mar;78:46-52. doi: 10.1016/j.cct.2018.11.001..
Keywords: Behavioral Health, Depression, Primary Care, Treatments
Graham AK, Minc A, Staab E
Validation of the computerized adaptive test for mental health in primary care.
This study compared the use of a computerized assessment tool with paper questionnaires to diagnose major depressive disorder (MDD) and general anxiety disorder (GAD). It was found that the majority of patients in the study preferred the computerized adaptive testing tool. Diagnostic accuracy of the tool was similar or higher than many of the traditional screening methods.
AHRQ-funded; HS000078.
Citation: Graham AK, Minc A, Staab E .
Validation of the computerized adaptive test for mental health in primary care.
Ann Fam Med 2019 Jan;17(1):23-30. doi: 10.1370/afm.2316..
Keywords: Anxiety, Depression, Diagnostic Safety and Quality, Behavioral Health, Primary Care, Screening
Moise N, Falzon L, Obi M
Interventions to increase depression treatment initiation in primary care patients: a systematic review.
Researchers investigated interventions for increasing depression treatment initiation in primary care settings. They found that collaborative/integrated care, preference treatment matching, and case management strategies had the best evidence for improving depression treatment initiation, but none of the strategies had high strength of evidence. While primary care settings can consider using some of these strategies when referring depressed patients to treatment, their review highlights the need for further rigorous research in this area.
AHRQ-funded; HS025198.
Citation: Moise N, Falzon L, Obi M .
Interventions to increase depression treatment initiation in primary care patients: a systematic review.
J Gen Intern Med 2018 Nov;33(11):1978-89. doi: 10.1007/s11606-018-4554-z..
Keywords: Patient-Centered Healthcare, Depression, Primary Care, Behavioral Health, Patient and Family Engagement
Lapham GT, Lee AK, Caldeiro RM
Prevalence of behavioral health conditions across frequency of cannabis use among adult primary care patients in Washington state.
This population-based study of primary care patients reports on the prevalence of common behavioral health conditions across cannabis use frequency. The investigators concluded that their study found a strong association between the frequency of cannabis use and tobacco use, depression symptoms, and other drug use, and as well as diagnosed mental health and substance use disorders.
AHRQ-funded; HS023173.
Citation: Lapham GT, Lee AK, Caldeiro RM .
Prevalence of behavioral health conditions across frequency of cannabis use among adult primary care patients in Washington state.
J Gen Intern Med 2018 Nov;33(11):1833-35. doi: 10.1007/s11606-018-4558-8..
Keywords: Behavioral Health, Depression, Primary Care, Substance Abuse, Tobacco Use
Moise N, Shah RN, Essock S
Sustainability of collaborative care management for depression in primary care settings with academic affiliations across New York State.
This study examined sustainability of collaborative care management for depression in primary care settings with academic affiliations across New York State. The investigators used descriptive statistics to assess implementation metrics in sustaining vs. opt-out clinics and trends in implementation fidelity 1 and 2 years into the sustainability phase among sustaining clinics.
AHRQ-funded; HS025198
Citation: Moise N, Shah RN, Essock S .
Sustainability of collaborative care management for depression in primary care settings with academic affiliations across New York State.
Implement Sci 2018 Oct 12;13(1):128. doi: 10.1186/s13012-018-0818-6..
Keywords: Care Coordination, Depression, Behavioral Health, Primary Care
Aalsma MC, Zerr AM, Etter DJ
Physician intervention to positive depression screens among adolescents in primary care.
The objective of this study was to determine the effectiveness of computer-based screening and physician feedback to guide adolescent depression management within primary care. The investigators found that when a computer-based decision support system algorithm focused on adolescent depression and was implemented in two primary care clinics, a majority of physicians utilized screening results to guide clinical care.
AHRQ-funded; HS022681.
Citation: Aalsma MC, Zerr AM, Etter DJ .
Physician intervention to positive depression screens among adolescents in primary care.
J Adolesc Health 2018 Feb;62(2):212-18. doi: 10.1016/j.jadohealth.2017.08.023..
Keywords: Care Management, Children/Adolescents, Shared Decision Making, Depression, Health Information Technology (HIT), Behavioral Health, Primary Care, Primary Care: Models of Care, Screening
Etter DJ, McCord A, Ouyang F
Suicide screening in primary care: use of an electronic screener to assess suicidality and improve provider follow-up for adolescents.
The purpose of this study was to assess the feasibility of using an existing computer decision support system to screen adolescent patients for suicidality and provide follow-up guidance to clinicians in a primary care setting. The authors concluded that incorporating adolescent suicide screening and provider follow-up guidance into an existing computer decision support system in primary care was feasible and well utilized by providers.
AHRQ-funded; HS022681.
Citation: Etter DJ, McCord A, Ouyang F .
Suicide screening in primary care: use of an electronic screener to assess suicidality and improve provider follow-up for adolescents.
J Adolesc Health 2018 Feb;62(2):191-97. doi: 10.1016/j.jadohealth.2017.08.026..
Keywords: Children/Adolescents, Clinical Decision Support (CDS), Shared Decision Making, Depression, Behavioral Health, Primary Care, Screening
Hines AL, Roter D, Ghods Dinoso BK
Informed and patient-centered decision-making in the primary care visits of African Americans with depression.
This study examined the prevalence and extent of informed decision-making (IDM) and patient-centered decision-making (PCDM) in primary care visits of African Americans with depression. It concluded that the associations between IDM and PCDM with interpersonal ratings were moderated by overall patient-centeredness of the visit, which may be indicative of broader cross-cultural communication issues. Strengthening partnerships between depressed African Americans and their clinicians may improve patient-engaged decision-making.
AHRQ-funded; HS013645.
Citation: Hines AL, Roter D, Ghods Dinoso BK .
Informed and patient-centered decision-making in the primary care visits of African Americans with depression.
Patient Educ Couns 2018 Feb;101(2):233-40. doi: 10.1016/j.pec.2017.07.027.
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Keywords: Shared Decision Making, Depression, Patient-Centered Healthcare, Primary Care, Racial and Ethnic Minorities
Biegler K, Mollica R, Sim SE
AHRQ Author: Ngo-Metzger Q
Rationale and study protocol for a multi-component health information technology (HIT) screening tool for depression and post-traumatic stress disorder in the primary care setting.
The authors described the rationale and protocol of a clustered randomized controlled trial to test the effectiveness of a health information technology (HIT) intervention that provides a multi-component approach to delivering culturally competent mental health care in the primary care setting. They expect the outcomes to include assessing the potential of the HIT intervention to improve screening rates, clinical detection, provider initiation of treatment, and patient outcomes for depression and post-traumatic stress disorder. They suggest that this technology has the potential to be adapted in order to facilitate mental health screening and treatment in the primary care setting.
AHRQ-authored.
Citation: Biegler K, Mollica R, Sim SE .
Rationale and study protocol for a multi-component health information technology (HIT) screening tool for depression and post-traumatic stress disorder in the primary care setting.
Contemp Clin Trials 2016 Sep;50:66-76. doi: 10.1016/j.cct.2016.07.001.
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Keywords: Health Information Technology (HIT), Behavioral Health, Depression, Screening, Primary Care
Ryu E, Chamberlain AM, Pendergraft RS
Quantifying the impact of chronic conditions on a diagnosis of major depressive disorder in adults: a cohort study using linked electronic medical records.
In this study, the researchers aimed to quantify the relative contribution of selected chronic conditions to identify the conditions most influential to major depressive disorder (MDD) risk in adults and identify differences by age. Their results suggest that specific chronic conditions such as diabetes mellitus and rheumatoid arthritis/osteoarthritis may have greater influence than others on the risk of MDD.
AHRQ-funded; HS023077.
Citation: Ryu E, Chamberlain AM, Pendergraft RS .
Quantifying the impact of chronic conditions on a diagnosis of major depressive disorder in adults: a cohort study using linked electronic medical records.
BMC Psychiatry 2016 Apr 26;16:114. doi: 10.1186/s12888-016-0821-x.
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Keywords: Chronic Conditions, Depression, Electronic Health Records (EHRs), Primary Care
Bogner HR, Joo JH, Hwang S
Does a depression management program decrease mortality in older adults with specific medical conditions in primary care? An exploratory analysis.
The objective of this study was to determine whether treating depression decreases mortality from various chronic medical conditions. It found evidence of a statistically significant intervention effect on mortality for diabetes mellitus in persons with major depression.
AHRQ-funded; HS023445.
Citation: Bogner HR, Joo JH, Hwang S .
Does a depression management program decrease mortality in older adults with specific medical conditions in primary care? An exploratory analysis.
J Am Geriatr Soc 2016 Jan;64(1):126-31. doi: 10.1111/jgs.13711..
Keywords: Chronic Conditions, Depression, Elderly, Mortality, Primary Care
Pfoh E, Mojtabai R, Bailey J
Impact of Medicare annual wellness visits on uptake of depression screening.
This study assessed whether patients with an initial annual wellness visit (AWV) were more likely to be screened for depression than those with a primary care visit. Fifteen percent of patients with non-AWVs and 10 percent of patients with AWVs received depression screening. After accounting for clustering, there was no statistically significant difference in depression screening by visit type.
AHRQ-funded; HS000029.
Citation: Pfoh E, Mojtabai R, Bailey J .
Impact of Medicare annual wellness visits on uptake of depression screening.
Psychiatr Serv 2015 Nov;66(11):1207-12. doi: 10.1176/appi.ps.201400524.
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Keywords: Depression, Screening, Medicare, Elderly, Primary Care
Radovic A, Reynolds K, McCauley HL
Parents' role in adolescent depression care: primary care provider perspectives.
This study aimed to understand how primary care providers (PCPs) perceive barriers to adolescent depression care in order to inform strategies to increase treatment engagement. PCPs perceived that parental unwillingness to accept the depression diagnosis, family dysfunction, and trauma were common barriers. PCPs contrasted this with examples of good family support they believed would enable adolescents to attend follow-up appointments and have a “life coach” at home.
AHRQ-funded; HS022989; HS019486.
Citation: Radovic A, Reynolds K, McCauley HL .
Parents' role in adolescent depression care: primary care provider perspectives.
J Pediatr 2015 Oct;167(4):911-8. doi: 10.1016/j.jpeds.2015.05.049..
Keywords: Caregiving, Children/Adolescents, Depression, Behavioral Health, Primary Care
Jolles MP, Haynes-Maslow L, Roberts MC
Mental health service use for adult patients with co-occurring depression and physical chronic health care needs, 2007-2010.
This study examines (1) whether the presence of chronic physical conditions is associated with mental health service use for individuals with depression who visit a primary care physician, and (2) whether race modifies this relationship. It found that most patient office visits (70 percent) where a depression diagnosis was recorded also had co-occurring chronic physical conditions recorded.
AHRQ-funded; HS000032.
Citation: Jolles MP, Haynes-Maslow L, Roberts MC .
Mental health service use for adult patients with co-occurring depression and physical chronic health care needs, 2007-2010.
Med Care 2015 Aug;53(8):708-12. doi: 10.1097/mlr.0000000000000389..
Keywords: Depression, Behavioral Health, Chronic Conditions, Primary Care