Prevalence of practice system tools for improving depression care among primary care clinics: the DIAMOND initiative

J Gen Intern Med. 2011 Sep;26(9):999-1004. doi: 10.1007/s11606-011-1739-0. Epub 2011 May 20.

Abstract

Background: Practice system tools improve chronic disease care, but are generally lacking for the care of depression in most primary care settings.

Objective: To describe the frequency of various depression-related practice system tools among Minnesota primary care clinics interested in improving depression care.

Design: Cross-sectional survey.

Participants: Physician leaders of 82 clinics in Minnesota.

Main measures: A survey including practice systems recommended for care of depression and chronic conditions, each scored on a 100-point scale, and the clinic's priority for improving depression care on a 10-point scale.

Key results: Fewer practice systems tools were present and functioning well for depression care (score = 24.4 [SD 1.6]) than for the care of chronic conditions in general (score = 43.9 [SD 1.6]), p < 0.001. The average priority for improving depression care was 5.8 (SD 2.3). There was not a significant correlation between the presence of practice systems for depression or chronic disease care and the priority for depression care except for a modest correlation with the depression Decision Support subscale (r = 0.29, p = 0.008). Certain staffing patterns, a metropolitan-area clinic location, and the presence of a fully functional electronic medical record were associated with the presence of more practice system tools.

Conclusions: Few practice system tools are in place for improving depression care in Minnesota primary care clinics, and these are less well-developed than general chronic disease practice systems. Future research should focus on demonstrating whether implementing these tools for depression care results in much-needed improvements in care for patients with depression.

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Ambulatory Care Facilities / standards*
  • Cross-Sectional Studies
  • Depressive Disorder / diagnosis
  • Depressive Disorder / epidemiology*
  • Depressive Disorder / therapy*
  • Follow-Up Studies
  • Humans
  • Minnesota
  • Practice Guidelines as Topic / standards*
  • Prevalence
  • Primary Health Care / methods
  • Primary Health Care / standards*