设计一项预防自杀的干预措施：PROSPECT（初级保健老年人群自杀预防：协作试验）。
Designing an intervention to prevent suicide: PROSPECT (Prevention of Suicide in Primary Care Elderly: Collaborative Trial).
作者信息
Bruce M L, Pearson J L
机构信息
Weill Medical College of Cornell University, White Plains, NY, USA.
出版信息
Dialogues Clin Neurosci. 1999 Sep;1(2):100-12. doi: 10.31887/DCNS.1999.1.2/mbruce.
Suicide is a major public health problem with greatest risk in the very old. This paper describes an approach to reducing the risk of suicide by intervening on depression in elderly primary care patients. Depression is an appropriate target for an intervention as it is highly prevalent in primary care, is a strong risk factor for suicide, and is more often than not inadequately treated. PROSPECT (Prevention of Suicide in Primary Care Elderly: Collaborative Trial) is a National institute of Mental Health (NIMH)-funded collaborative study that is testing this approach to suicide risk prevention in 18 primary care practices in the United States. PROSPECT'S intervention of "guideline management" introduces a health specialist into the primary care setting to help physicians provide "on-time, on-target" treatment and long-term management of late-life depression following structured clinical guidelines. The effectiveness of the intervention in reducing suicidal risk and depression is evaluated by following a representative sample of older patients identified using a 2-stage design.
自杀是一个重大的公共卫生问题，在高龄人群中风险最高。本文描述了一种通过干预老年初级保健患者的抑郁症来降低自杀风险的方法。抑郁症是干预的合适目标，因为它在初级保健中非常普遍，是自杀的一个强有力的风险因素，而且往往治疗不充分。“初级保健老年人自杀预防：协作试验”（PROSPECT）是一项由美国国立精神卫生研究所（NIMH）资助的协作研究，正在美国18个初级保健机构中测试这种预防自杀风险的方法。PROSPECT的“指南管理”干预措施引入了一名健康专家到初级保健环境中，以帮助医生按照结构化临床指南提供“及时、精准”的治疗和对晚年抑郁症的长期管理。通过对使用两阶段设计确定的具有代表性的老年患者样本进行跟踪，评估该干预措施在降低自杀风险和抑郁症方面的有效性。
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