Truitt Frances E, Pina Beatrice J, Person-Rennell Nicole H, Angstman Kurt B
Department of Family Medicine, Neighborhood Healthsource, Minneapolis, MN, USA.
Qual Prim Care. 2013;21(3):171-7.
Even with routine screening, women diagnosed with postpartum depression (PPD) often experience delays in treatment with consequences affecting mother, infant, families and communities. A collaborative care management (CCM) approach may provide more timely, effective and higher quality of care for women suffering from postpartum depression.
This study compared the outcomes of women diagnosed with depression within a year of giving birth, comparing management using a collaborative care model with routine primary care.
In a retrospective quantitative cohort pilot study (n = 78), the outcomes of days to first follow-up, one-year healthcare utilisation, remission rates and other quality metrics were investigated.
Those who were managed with CCM had fewer days to first follow-up (6.1 versus 31.4; P < 0.01), were more likely to meet the quality metrics of three or more related contacts in the three months after diagnosis (P < 0.01), and had documented Patient Health Questionnaire (PHQ-9) or Edinburgh Postnatal Depression Scale (EPDS) measurements at 3 (P < 0.01), 6 (P < 0.01) and 12 (P < 0.01) months. With an intention to treat model, 6-month remission rates were improved with CCM (46.7 vs. 6.3%, P <0.01). Those managed collaboratively versus routinely used healthcare in the year following diagnosis at similar rates.
A CCM model offers timelier and higher quality care to women suffering from PPD, without contributing to higher healthcare utilisation.
即便进行常规筛查，被诊断为产后抑郁症（PPD）的女性往往在治疗上会出现延迟，其后果会影响母亲、婴儿、家庭和社区。协作式护理管理（CCM）方法可能为患有产后抑郁症的女性提供更及时、有效和更高质量的护理。
本研究比较了在分娩后一年内被诊断为抑郁症的女性的治疗结果，将使用协作式护理模式的管理与常规初级护理进行了对比。
在一项回顾性定量队列试点研究（n = 78）中，调查了首次随访天数、一年医疗保健利用率、缓解率和其他质量指标的结果。
接受CCM管理的患者首次随访天数更少（6.1天对31.4天；P < 0.01），在诊断后三个月内更有可能达到三次或更多相关接触的质量指标（P < 0.01），并且在3个月（P < 0.01）、6个月（P < 0.01）和12个月（P < 0.01）时有记录的患者健康问卷（PHQ-9）或爱丁堡产后抑郁量表（EPDS）测量值。采用意向性治疗模型，CCM提高了6个月的缓解率（46.7%对6.3%，P <0.01）。在诊断后的一年中，接受协作式管理与常规管理的患者使用医疗保健的比例相似。
CCM模型为患有PPD的女性提供了更及时、更高质量的护理，且不会导致更高的医疗保健利用率。
