Evaluation of the Achieving Depression and Anxiety Patient Centered Treatment (ADAPT) Program

Evaluating the Implementation and Outcomes of the Achieving Depression and Anxiety Patient Centered Treatment (ADAPT) Collaborative Care Program in A Large, Integrated Healthcare System: A Mixed Methods Observational Study Protocol

Depression and anxiety are increasingly common conditions for which primary care providers (PCPs) serve as the initial healthcare contact for most patients. Comorbid depression and anxiety result in higher costs, and treatment as usual, which is referrals to specialty psychiatric care, often contribute to delays in care. Collaborative psychiatric care is an evidence-based strategy to increase mental healthcare access while reducing costs. ADAPT is a novel collaborative care model. By using technology-driven appointments with providers, ADAPT increases access to mental healthcare, and reduces member wait times. This mixed methods study will assess implementation measures of the ADAPT program and the components of ADAPT related to patient mental health improvement compared to specialty mental health care. The hypothesis is that: ADAPT program will have good program reach and efficacy. We will examine program implementation and maintenance. Further, the study looks to uncover member and program characteristics that are associated with depression and anxiety remission and care utilization.

Inclusion Criteria:

• Adult Outcomes Questionnaire (AOQ) score between 10-30
• English-Speaking

Exclusion Criteria:

• High risk for suicide defined by answer to question 9 on PHQ-9 of 1 or more
• Diagnosis of bipolar disorder
• Diagnosis of a psychotic disorder
• Dementia diagnosis
• Active substance use disorder diagnosis
• Current hospice
• Current home-based palliative care
• Residing in a skilled nursing facility
• Residing in an assisted living facility
• Non-Kaiser Permanente Member
• Established psychiatric care outside of Kaiser Permanente