Clinical depression follow-up: Difference between revisions
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==Overview== | ==Overview== | ||
Patients with clinical depression should be followed up four to six weeks following the initiation of the treatment to assess for | |||
Patients with clinical depression should be followed-up four to six weeks following the initiation of the treatment to assess for improvement of symptoms and treatment adherence.<ref name="VA">VA/DoD [http://www.healthquality.va.gov/guidelines/MH/mdd/ clinical practice guideline for the management of major depressive disorder (MDD)]. Guideline summary. Washington (DC): Department of Veterans Affairs (U.S.); 2009</ref><ref name="apa">American Psychiatric Association (APA). [http://psychiatryonline.org/content.aspx?bookid=28§ionid=1667485 Practice guideline for the treatment of patients with major depressive disorder]. 3rd ed. Arlington (VA): American Psychiatric Association (APA); 2010 Oct. 152 p. [1170 references] {{doi|10.1176/appi.books.9780890423387.654001}}</ref> This is based on [[clinical practice guideline]]s by the [http://www.va.gov/ Veteran Affairs]/[http://www.defense.gov/ Department of Defense] (VA/DoD) and [http://psychiatryonline.org American Psychiatric Association]. | |||
==Follow-up== | ==Follow-up== | ||
The Veteran Affairs/Department of Defense (VA/DoD) clinical practice | The [http://www.va.gov/ Veteran Affairs]/[http://www.defense.gov/ Department of Defense] (VA/DoD) [[clinical practice guideline]]s for management of major depressive disorder recommends the following regarding the follow-up of patients:<ref name="VA">VA/DoD [http://www.healthquality.va.gov/guidelines/MH/mdd/ clinical practice guideline for the management of major depressive disorder (MDD)]. Guideline summary. Washington (DC): Department of Veterans Affairs (U.S.); 2009</ref> | ||
* The follow-up period from the time of initial diagnosis is four to six weeks. | * The follow-up period from the time of initial diagnosis is four to six weeks. | ||
* At time of follow-up, a repeat PHQ-9 and an evaluation of the risk for suicide should be completed in order to assess treatment response. | * At time of follow-up, a repeat PHQ-9 and an evaluation of the risk for suicide should be completed in order to assess treatment response. | ||
* How well treatment was tolerated, adherence to treatment, other influential medical problems, and psychosocial barriers to therapy should also be addressed at the time of follow-up. | * How well treatment was tolerated, adherence to treatment, other influential medical problems, and psychosocial barriers to therapy should also be addressed at the time of follow-up. | ||
===Evidence=== | |||
Two [[randomized controlled trial]]s found improved outcomes using 'measurement-based care' to monitor patients.<ref name="pmid26315978">{{cite journal| author=Guo T, Xiang YT, Xiao L, Hu CQ, Chiu HF, Ungvari GS et al.| title=Measurement-Based Care Versus Standard Care for Major Depression: A Randomized Controlled Trial With Blind Raters. | journal=Am J Psychiatry | year= 2015 | volume= 172 | issue= 10 | pages= 1004-13 | pmid=26315978 | doi=10.1176/appi.ajp.2015.14050652 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26315978 }} Trial registration is not clear </ref><ref name="pmid22807244">{{cite journal| author=Yeung AS, Jing Y, Brenneman SK, Chang TE, Baer L, Hebden T et al.| title=Clinical Outcomes in Measurement-based Treatment (Comet): a trial of depression monitoring and feedback to primary care physicians. | journal=Depress Anxiety | year= 2012 | volume= 29 | issue= 10 | pages= 865-73 | pmid=22807244 | doi=10.1002/da.21983 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22807244 }} </ref> | |||
A more recent [[systematic review]] by the [[Cochrane Collaboration]] did not find benefit from measurement-based care.<ref name="pmid27409972">{{cite journal| author=Kendrick T, El-Gohary M, Stuart B, Gilbody S, Churchill R, Aiken L et al.| title=Routine use of patient reported outcome measures (PROMs) for improving treatment of common mental health disorders in adults. | journal=Cochrane Database Syst Rev | year= 2016 | volume= 7 | issue= | pages= CD011119 | pmid=27409972 | doi=10.1002/14651858.CD011119.pub2 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27409972 }} </ref> However, the Cochrane review did not include the Comet trial and the trial by Guo. Comet was excluded for choice of outcome and Gui was not mentioned by the Cochrane. | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Latest revision as of 15:16, 26 July 2016
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Risk calculators and risk factors for Clinical depression follow-up |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Patients with clinical depression should be followed-up four to six weeks following the initiation of the treatment to assess for improvement of symptoms and treatment adherence.[1][2] This is based on clinical practice guidelines by the Veteran Affairs/Department of Defense (VA/DoD) and American Psychiatric Association.
Follow-up
The Veteran Affairs/Department of Defense (VA/DoD) clinical practice guidelines for management of major depressive disorder recommends the following regarding the follow-up of patients:[1]
- The follow-up period from the time of initial diagnosis is four to six weeks.
- At time of follow-up, a repeat PHQ-9 and an evaluation of the risk for suicide should be completed in order to assess treatment response.
- How well treatment was tolerated, adherence to treatment, other influential medical problems, and psychosocial barriers to therapy should also be addressed at the time of follow-up.
Evidence
Two randomized controlled trials found improved outcomes using 'measurement-based care' to monitor patients.[3][4]
A more recent systematic review by the Cochrane Collaboration did not find benefit from measurement-based care.[5] However, the Cochrane review did not include the Comet trial and the trial by Guo. Comet was excluded for choice of outcome and Gui was not mentioned by the Cochrane.
References
- ↑ 1.0 1.1 VA/DoD clinical practice guideline for the management of major depressive disorder (MDD). Guideline summary. Washington (DC): Department of Veterans Affairs (U.S.); 2009
- ↑ American Psychiatric Association (APA). Practice guideline for the treatment of patients with major depressive disorder. 3rd ed. Arlington (VA): American Psychiatric Association (APA); 2010 Oct. 152 p. [1170 references] doi:10.1176/appi.books.9780890423387.654001
- ↑ Guo T, Xiang YT, Xiao L, Hu CQ, Chiu HF, Ungvari GS; et al. (2015). "Measurement-Based Care Versus Standard Care for Major Depression: A Randomized Controlled Trial With Blind Raters". Am J Psychiatry. 172 (10): 1004–13. doi:10.1176/appi.ajp.2015.14050652. PMID 26315978. Trial registration is not clear
- ↑ Yeung AS, Jing Y, Brenneman SK, Chang TE, Baer L, Hebden T; et al. (2012). "Clinical Outcomes in Measurement-based Treatment (Comet): a trial of depression monitoring and feedback to primary care physicians". Depress Anxiety. 29 (10): 865–73. doi:10.1002/da.21983. PMID 22807244.
- ↑ Kendrick T, El-Gohary M, Stuart B, Gilbody S, Churchill R, Aiken L; et al. (2016). "Routine use of patient reported outcome measures (PROMs) for improving treatment of common mental health disorders in adults". Cochrane Database Syst Rev. 7: CD011119. doi:10.1002/14651858.CD011119.pub2. PMID 27409972.