IMPROVING PRIMARY CARE SERVICES: PERSONAL ILLNESS MODELS

改善初级保健服务：个人疾病模型

• 批准号: 6392691
• 负责人: CHARLOTTE BROWN
• 金额: $ 40.36万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-09-01 至 2004-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6392691
• 关键词: antidepressants; clinical research; depression; health behavior; health care model; health care quality; health care service evaluation; health services research tag; human subject; longitudinal human study; managed care; mental disorder chemotherapy; patient care management; primary care physician; therapy compliance; antidepressants; clinical research; depression; health behavior; health care model; health care quality; health care service evaluation; health services research tag; human subject; longitudinal human study; managed care; mental disorder chemotherapy; patient care management; primary care physician; therapy compliance

DESCRIPTION (Applicant's abstract): This revised R01 application will examine the links between personal illness models and depression treatment adherence in primary care patients using state-of-the-art medication monitoring techniques. It will also explore their relationship to symptomatic and functional outcomes. By examining these complex relationships naturalistically, this research will lay the foundation for the design of intervention strategies to promote adherence to depression treatment in primary care practice. We propose to examine, over a 12-month period, the extent of nonadherence to pharmacologic treatment for depression among primary care patients, and to use Levanthal's self-regulatory model of illness cognition to evaluate the influence of these beliefs or representations of depressive illness on medication adherence. This study uses a longitudinal design to assess changes in these perceptions and treatment adherence over time Two hundred and ten primary care patients age 18 and older will be recruited from two family practice health centers and a network of eight family practice offices. Potential participants will be referred by their primary care physician Physicians will be asked to refer patients who have initiated antidepressant treatment within the preceding two weeks. Patients providing informed consent will complete five psychosocial assessments in a 12-month period (i.e., baseline, and months 3, 6, 9, and 12). Medication adherence will be assessed at these visits by patient self-report and electronic pill monitors. The proposed study will provide important information on patterns of nonadherence to antidepressant treatment the primary care sector during both acute and continuation phases of pharmacotherapy. It will also be the first study to examine illness representations for depression and their relationship to treatment adherence, and to assess change in personal illness models over time. The findings from this study will form the basis for development of adherence interventions, which are tailored to patients' self-management needs. Subsequent studies will be designed to evaluate the effectiveness of such interventions in the primary care sector.

描述（申请人的摘要）：此修订后的R01申请将检查 个人疾病模型与抑郁治疗依从性之间的联系 初级保健患者使用最先进的药物监测技术。 它还将探索他们与症状和功能结果的关系。 通过自然观察这些复杂的关系，这项研究将 为设计策略设计奠定基础 在初级保健实践中遵守抑郁症治疗。我们建议 在12个月内检查药理学的不遵守程度 初级保健患者的抑郁症治疗，并使用Levanthal's 疾病认知的自我调节模型，以评估这些认知的影响 抑郁症依从性的信念或表征。 这项研究使用纵向设计来评估这些看法的变化 和随着时间的时间的治疗依从性，有22个初级保健患者年龄 18岁及以上的人将从两个家庭练习中心招募 由八个家庭练习办公室组成的网络。潜在的参与者将 由他们的初级保健医师转介的医生将被要求参考 在前两个开始启动抗抑郁治疗的患者 几周。提供知情同意的患者将完成五个社会心理 在12个月内的评估（即基线和第3、6、9和12个月）。 患者自我报告将在这些访问中评估药物依从性 和电子药监测器。 拟议的研究将提供有关模式的重要信息 不依赖抗抑郁药治疗双方的初级保健部门 药物治疗的急性和延续阶段。这也将是第一个 研究以检查抑郁症及其关系的疾病表征 治疗依从性，并评估个人疾病模型的变化 时间。这项研究的发现将构成发展的基础 依从性干预措施是针对患者的自我管理需求量身定制的。 随后的研究将旨在评估此类的有效性 初级保健部门的干预措施。