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Depression is one of the most common conditions among primary care patients. Nevertheless, there are several problems in depression diagnosis, clinical management and outcomes. The INDI study, which is based in a collaborative care model, aims to improve the management of depression in primary care patients. It is intended to be implemented in clinical practice within the context of primary care.
BACKGROUND Depression is one of the most common conditions among primary care patients. Nevertheless, there are several problems in its diagnosis, clinical management and outcomes. The INDI study, which is based in a collaborative care model, aims to improve the management of depression in primary care patients. INDI has been proved previously to be an efficient intervention showing clinical and socio-economic benefits. INDI is intended to be implemented in the clinical practice within the context of primary care.
METHOD Aim: Test the feasibility and the impact of an implementation strategy of the INDI model for the management of depression in primary care.
Design: This is a casi-experimental study within the context of primary care. Specific geographic areas will be identified to implement the INDI program (intervention group) and other areas with similar features will to be compared (control group.
Participants: Patients diagnosed with depression will be invited to voluntarily participate in this study. Additionally, the investigators will also consider as participants the health professionals, the centres of primary care, as well as the health organizations of the geographic areas where the study will take place: Camp de Tarragona and Valles Occidental (Catalonia, Spain).
Intervention: The INDI model is a health care program for improving the management of depression. INDI includes clinical, training and organizational interventions with the participation of nurses as care managers. An active strategy based on the Promoting Action on Research Implementation in Health Services's model (PARIHS) will be designed for the implementation.
Evaluation: This study will use qualitative and quantitative methods to obtain data on the variables related to a successful implementation: feasibility, acceptability, and impact.
Discussion: In this study, the investigators aim to test the feasibility of a clinical intervention INDI, based on a collaborative care model, in the management of depression in primary care setting. If the implementation of such intervention is successful, then the achieved data and experience will help to plan a strategy to generalize the INDI model to the Catalan health system. The investigators expect significant clinical benefits to the patients, the health system and to the society.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intervention: INDI Implementation | Experimental | Primary care centres which will implement the collaborative (INDI) care model for depression |
|
| Control: no INDI implementation | No Intervention | Primary care centres in which the collaborative care strategy INDI will not be implemented, but will be compared in terms of their clinical practice towards depression |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Intervention: INDI Implementation | Other | Implementation of a collaborative care model in the context of primary care to manage depression |
|
| Measure | Description | Time Frame |
|---|---|---|
| degree of implementation and capacity for change of the collaborative care model (INDI) | degree of implementation of the collaborative care model (INDI) in health organization and professionals using the Assessment of Readiness for Chronicity in Health Care Organizations (ARCHO) | 12 months |
| patient experience about the collaborative care model (INDI) | how patients experience depression care according to the collaborative care model (INDI) using the Instrument for Evaluating Patient Experience of Chronic Illness Care (IEXPAC) scale | 12 months |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Catarina Pires, PhD | Contact | 0034 652957478 | jamnista@gmail.com |
| Name | Affiliation | Role |
|---|---|---|
| Enric Aragonès, PhD | Jordi Gol Fundation | Principal Investigator |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 15242139 | Background | Aragones E, Pinol JL, Labad A, Masdeu RM, Pino M, Cervera J. Prevalence and determinants of depressive disorders in primary care practice in Spain. Int J Psychiatry Med. 2004;34(1):21-35. doi: 10.2190/C25N-W4NY-BN8W-TXN2. | |
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| ID | Term |
|---|---|
| D003863 | Depression |
| ID | Term |
|---|---|
| D001526 | Behavioral Symptoms |
| D001519 | Behavior |
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| 35382822 | Derived | Aragones E, Lopez-Cortacans G, Cardoner N, Tome-Pires C, Porta-Casteras D, Palao D; INDI.I Research Team. Barriers, facilitators, and proposals for improvement in the implementation of a collaborative care program for depression: a qualitative study of primary care physicians and nurses. BMC Health Serv Res. 2022 Apr 5;22(1):446. doi: 10.1186/s12913-022-07872-z. |
| 29237444 | Derived | Aragones E, Palao D, Lopez-Cortacans G, Caballero A, Cardoner N, Casaus P, Cavero M, Monreal JA, Perez-Sola V, Cirera M, Loren M, Bellerino E, Tome-Pires C, Palacios L. Development and assessment of an active strategy for the implementation of a collaborative care approach for depression in primary care (the INDI.i project). BMC Health Serv Res. 2017 Dec 13;17(1):821. doi: 10.1186/s12913-017-2774-2. |