A System for Management of Depression in Medical Illness

医疗疾病抑郁症管理系统

• 批准号: 6943124
• 负责人: THOMAS J MCLAUGHLIN
• 金额: $ 49.22万
• 依托单位: HARVARD PILGRIM HEALTH CARE, INC.
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-09-01 至 2009-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6943124
• 关键词: allied health education; asthma; chronic disease /disorder; clinical research; comorbidity; computer assisted medical decision making; computer system design /evaluation; congestive heart failure; depression; diabetes mellitus; disease /disorder proneness /risk; health care policy; health care professional practice; health care quality; health services research tag; human subject; interview; mathematical model; medical complication; mental disorder diagnosis; mental health information system; mental health services; patient care management; statistics /biometry; training

DESCRIPTION (provided by applicant): This Intervention and Practice Research Infrastructure Support Program (IP-RISP) application seeks funding to support conceptual, methodological, and organizational development to foster depression intervention research among primary care patients with chronic medical illness. The proposed development activities shaped by past and ongoing work will allow investigators to advance knowledge of depression among medically ill patients by using new concepts, measurement and statistical tools and by creating information systems integrated at the patient level. IP RISP funding would allow us to continue development of important goals that we have pursued since 1995 and represent unique strengths of this application. We have made important progress in the following four areas that are relevant to this application: 1) Integration of mental health research activities into the clinical management and strategic planning activities of HPHC; 2) design of innovative interventions to deliver mental health services to primary care populations at high risk of depression; 3) development of applications of new statistical theory for outcomes assessment and quality measurement; 4) access to a large clinical population in a network model of care enabling us to conduct research in real-world settings. The goal of infrastructure building will be accomplished through the following specific activities. 1. We will develop an information technology enabled disease management system for depression (ITEMSD) occurring in medically ill patients in primary care settings that will include a system for reporting and alerting disease managers about potential gaps in care; a disease manager guideline and documentation system that suggests actions to be pursued; a system for the disease manager to communicate patient assessments, alerts and actions taken to other staff and providers. Consumer preferences will be incorporated into the design of ITEMS-D through use of standard qualitative methods. 2. The team will train disease managers in the principles of Social Learning Theory (SLT) that serves as the theoretical foundation of ITEMS-D, particularly its self-efficacy construct. 3. The research team will work with the HPHC Chief Information Officer and the technology vendor, Perot Systems to design the ITEMS-D database so that it will be easily integrated into all of HPHC's patient-level information systems facilitating rapid access to patient data. 4. Infrastructure development will be used to leverage ITEMS-D to conduct pilot studies related to infrastructure development and the development of RO1, R21 and other grant applications. The experience and talents of the research team working in partnership with HPHC's clinical leadership will allow us to continue building capacity to develop depression intervention research in medically ill populations. We expect that development of ITEMS-D would address the needs of health care delivery systems and serve as the platform for launching future interventions beginning with medically ill populations but extending to other high-risk groups at high risk for depression and other common mental disorders.

描述（由申请人提供）：该干预和实践研究基础设施支持计划 (IP-RISP) 申请寻求资金支持概念、方法和组织发展，以促进患有慢性疾病的初级保健患者的抑郁症干预研究。根据过去和正在进行的工作制定的拟议开发活动将使研究人员能够通过使用新概念、测量和统计工具以及创建在患者层面集成的信息系统来增进对医学疾病患者抑郁症的了解。 IP RISP 资金将使我们能够继续实现自 1995 年以来一直追求的重要目标，并代表了该应用程序的独特优势。我们在与该应用相关的以下四个领域取得了重要进展： 1）将心理健康研究活动纳入 HPHC 的临床管理和战略规划活动； 2) 设计创新干预措施，为抑郁症高危人群提供心理健康服务； 3）开发新统计理论在结果评估和质量测量中的应用； 4）通过网络护理模式接触大量临床人群，使我们能够在现实环境中进行研究。基础设施建设目标将通过以下具体活动来实现。 1. 我们将开发一个信息技术支持的抑郁症疾病管理系统（ITEMSD），该系统针对初级保健机构中的患病患者，其中包括一个用于报告和提醒疾病管理人员有关护理中潜在差距的系统；疾病管理者指南和文件系统，建议采取的行动；疾病管理者向其他工作人员和提供者传达患者评估、警报和采取的行动的系统。通过使用标准定性方法，消费者偏好将被纳入 ITEMS-D 的设计中。 2. 该团队将根据社会学习理论 (SLT) 原则对疾病管理人员进行培训，该理论是 ITEMS-D 的理论基础，特别是其自我效能感构建。 3. 研究团队将与 HPHC 首席信息官和技术供应商 Perot Systems 合作设计 ITEMS-D 数据库，使其能够轻松集成到 HPHC 的所有患者级信息系统中，从而促进快速访问患者数据。 4. 基础设施开发将利用ITEMS-D开展与基础设施开发相关的试点研究以及RO1、R21和其他赠款申请的开发。研究团队与 HPHC 临床领导层合作的经验和才能将使我们能够继续建设能力，在医学疾病人群中开展抑郁症干预研究。我们预计 ITEMS-D 的开发将满足医疗保健服务系统的需求，并作为启动未来干预措施的平台，从患病人群开始，扩展到其他患有抑郁症和其他常见精神障碍的高风险人群。