Depression

Reducing Disparities and Improving Care for Depression in Ob/Gyn Clinics (R01)

Jennifer Melville, MD, MPH

In the proposed randomized controlled trial, 260 Ob/Gyn clinic patients with major depression and/or dysthymia will be assigned to either 1) an integrated depression intervention or 2) usual care. We will screen ~8,300 patients presenting for scheduled clinic appointments at 2 urban Ob/Gyn clinics over 18 months for major depression/dysthymia. A large number of these patients are low-income and minority women. Potentially eligible patients may also be referred by a clinic provider or reply to informational fl yers posted in the clinics. We will enroll a total of 260 patients in the trial. The integrated depression intervention will last 12 months. Outcomes will be assessed at baseline and at 6, 12 and 18 months post-baseline by telephone interviews by research staff who are blinded to study arm.

The Primary Aims of our proposal are to evaluate the impact of an integrated Ob/Gyn depression intervention on:

1. depression treatment outcomes, including change in depressive symptoms and depression treatment response


2. functional outcomes, including functional status and quality of life

The Secondary Aims of our proposal are to:

1. evaluate the impact of an integrated Ob/Gyn depression intervention on quality of depression care indicators, including reaching adequate dose and duration of antidepressant medications, adherence to antidepressants during follow-up, and number of therapy visits; and on satisfaction with depression care, including patient satisfaction, provider satisfaction, and provider attitudes toward depression care in the Ob/Gyn clinical setting


2. develop a model of sustainability by setting up systems and training existing clinical staff to continue the integrated Ob/Gyn depression intervention at study end

Funding Source: NIH
Contact: Jennifer Melville, MD, MPH, (206) 744-6272
Ends: 5/31/2014