Collaborative Care for Treatment of Depression and Anxiety

Summary

The goal of this project is to evaluate the effectiveness of a collaborative care model for primary care patients at Kaiser Permanente Colorado (KPCO) with depression and/or anxiety. Collaborative care uses evidence-based short-term treatments delivered to patients over the phone. We will explore the use of cost-efficient automated processes for patient outreach and follow-up, such as care pools of patients and using patient portal messaging, risk-based results routing to providers, and electronic health record (EHR) tools for patient tracking and outcome assessment. Using a cluster randomized design, we will compare results between clinics that are offering collaborative care to those that are not.

Eligibility

Inclusion Criteria:

* 18+
* Current membership and active on patient portal
* Depression Diagnosis in the prior year
* Overdue for PHQ9 Screening based on the following criteria:

  * High Risk: Last PHQ9 screener was completed greater than 4 months ago AND total Score is greater than or equal 10 or item 9 is greater than 0.
  * Low Risk: Last PHQ9 screener was completed greater than 12 months ago AND Last PHQ9 Total Score is less than 10 and item 9 is equal to 0.
* Anxiety diagnoses in the prior year
* Has a baseline GAD7 in the same prior year; score = 10+ (\*Note: Provider referrals could be GAD7 score of 7 or higher)
* No Behavioral Health (BH) engagement in the prior year
* Patient is not in a Skilled Nursing Facility or Hospice
* Patient has no record of psychiatric hospitalization in the last year
* Patient does not need an interpreter (i.e., English speaking)
* Primary care location is one of the intervention clinics

Exclusion Criteria:

• Exclude individuals with any of the following diagnoses:

* Psychosis
* Dementia
* Bipolar
* Personality Disorders
* Post Traumatic Stress Disorder (PTSD)
* Obsessive Compulsive Disorder (OCD)
* Panic Disorder
* Cognitive Disorder

Conditions2

Locations1 site

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