Quality in Primary Care Open Access

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Abstract

Outcomes for collaborative care versus routine care in the management of postpartum depression

Frances E Truitt, Beatrice J Pina, Nicole H Person-Rennell, Kurt B Angstman

BackgroundEven with routine screening, women diagnosedwith postpartumdepression (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. AimsThis 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. MethodsIn 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. ResultsThose 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 (P0.01) 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. Conclusions A CCM model offers timelier and higher quality care to women suffering from PPD, without contributing to higher healthcare utilisation.