Study aims to reshape delivery of care, effectiveness of treatment for those with depression through measurement-based care model
Centerstone Research Institute has partnered with Indiana University’s Dr. Cara Lewis on a study to explore practical and more effective measurement-based care models in the treatment of depression. These models have the potential to treat people with depression more effectively and efficiently, reducing costs for both patients and community mental health centers. Details on the study were published in Implementation Science, a leading journal promoting the scientific study of methods to promote bringing innovative research findings into everyday practice in clinical work.
“Depression is one of the world’s leading causes of illness burden, costing the U.S. nearly $80 billion in annual lost work and wages,” said Dr. John Putz, operations manager for research & evaluation at Centerstone Research Institute. “Although measurement-based care has been proven effective in both its reach and utility, only about 20 percent of clinicians routinely measure mental health symptoms prior to each session. This study will help raise that number by identifying new approaches to implementing measurement-based care in community mental health centers, ensuring clinicians and patients benefit from the latest and most effective care models.”
In a paper titled, “Implementing measurement-based care (iMBC) for depression in community mental health: a dynamic cluster randomized trial study protocol,” researchers from Indiana University’s Department of Physiological and Brain Sciences and Centerstone Research Institute discussed the use of measurement-based care in the treatment of depression and how new models can help community mental health centers deliver care more quickly and more effectively.
The traditional approach to delivering impactful evidence-based patient care integrates complex multi-component practices into care delivery, which leads to a number of significant challenges for healthcare providers. Measurement-based care, on the other hand, is an evidence-based intervention framework that uses routine symptom measurement to inform treatment. This care model has been particularly effective in improving outcomes for individuals suffering from depression and has the potential to reach and help patients in a more timely and effective way.
The researchers propose a 30-month dynamic cluster randomized trial of standardized versus tailored measurement-based care across four cohorts in 12 Centerstone clinics—one of the largest providers of community-based mental health services in the U.S.—to collect quantitative and qualitative data from 187 clinicians and 625 clients with depression.
Through a mixed methods implementation-effectiveness hybrid design, researchers will be able to evaluate two conditions on both the clinician level (measurement-based care fidelity) and the client level (changes in depression symptoms). Additionally, identifying contextual factors—such as attitudes, resources and process—will mediate measurement-based care fidelity and optimize client outcomes.
Upon completion, the study has potential to impact public health by identifying practical and generalizable approaches to implementing measurement-based care into community mental health centers. Additionally, the evaluation of contextual mediators across diverse Centerstone sites included in the study may reveal common barriers to be directly addressed in future research.
To read the full paper in Implementation Science, visit http://www.implementationscience.com/content/10/1/127.
The pre-implementation phase (Phase 0) of the study was completed in May 2015. Phase 1 of the study began in June 2015 with subject recruitment and initial data collection for the first cohort of clinic sites.