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Top 30 Quality Measures

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Top 30 Quality Measures

Follow-up for Anti-Depressant Treatment Overall Rank: 7
For individuals being treated with antidepressants, establish and maintain follow-up contact (e.g. office visits, phone calls, or other) at intervals tailored to their mental health status.
Domain : Continuity
Services are offered as a coherent and coordinated succession of events in keeping with the health needs and personal context of patients. Health care is linked to other services to support successful treatment.
Rationale
Improving attitudes toward antidepressant medications along with the patients ability to handle medications side-effects and key factors in promoting greater adherence to maintenance treatment and thus greater likelihood of preventing relapse. Interventions toward this end may include patient visits with a depression prevention specialist (PhD, MSN, MSW who has received special training) and follow-up phone calls. Interventions are critical to educating the patients regarding the importance of preventing relapse, safety and efficacy of medications and management of potential side effects.

The prevention of relapse is of primary importance in the treatment of major depression. From 50 to 85% of people who suffer an episode of major depression will have a recurrence, usually within two or three years. Patients who have had three or more episodes of major depression are at 90% risk of having another episode. Cognitive Behavioral Therapy and Interpersonal Therapy help protect against/prevent relapse.
Primary Reference
Institute for Clinical Systems Improvement. (2006). Major Depression in Adults in Primary Care. Retrieved July 13, 2006, from http://www.icsi.org/display_file.asp? FileId=168 &title=Depression,%20Major,%20In%20Adults%20in%20Primary%20Care
Level of Evidence
I: Consistently higher quality studies specifically focused on primary mental health care.

Summarized CommentsAdd Comment
  • This is imperative as some anti-depressants can trigger manic episodes.
  • No show is a key indicator of stress, diminished capacity. In work situations, substance abuse most commonly manifests in absenteeism rather than on-the-job impairment
  • The medications themselves should be closely monitored
Variation in Results
Ratings-based Rank
Relevance 12
Actionability 8
Overall Importance 11
 
Stakeholder Rank
Academics 1
Clinicians 4
Consumers 38
Decision Makers 10
 
Special Group Rank
First Nations 6
Rural Areas 42
Federal Stakeholders 1
Regional Rank
BC AB SK MB ON QC NB NS PE NL YT NT NU
20 18 13 42 20 8 9 16 22 46 101 32 37
 
Overall Rank

      

7


SW04a (B640)

 
Distribution of Survey Respondent Ratings
Relevance
100
90
80
70
60
50
40
30
20
10
0
0 0 1.07 0 2.14 1.61 7.54 48.43 39.21
1 2 3 4 5 6 7 8 9
Low High
Actionability
100
90
80
70
60
50
40
30
20
10
0
0 0 0.72 1.07 1.5 7.17 14.02 40.77 34.75
1 2 3 4 5 6 7 8 9
Low High
Overall Importance
100
90
80
70
60
50
40
30
20
10
0
1.95 9.69 88.36
3 2 1

3 = can live without
2 = nice to have
1 = indispensable

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The views expressed herein do not necessarily represent the official policies of Health Canada