Rationale and study protocol for a multi-component Health Information Technology (HIT) screening tool for depression and post-traumatic stress disorder in the primary care setting

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• 作者：Kelly Biegler^a ; Richard Mollica^b ; Susan Elliott Sim^c ; Elisa Nicholas^d ; ^e ; Maria Chandler^d ; ^e ; Quyen Ngo-Metzger^f ; Kittya Paigne^g ; Sompia Paigne^g ; Danh V. Nguyen^a ; ^h ; Dara H. Sorkin^a ; ^{dsorkin@uci.edu" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Health Information Technology ; Primary care ; Limited English proficiency ; Cambodian refugees ; Depression ; post-traumatic stress disorder (PTSD)
• 刊名：Contemporary Clinical Trials
• 出版年：2016
• 出版时间：September 2016
• 年：2016
• 卷：50
• 期：Complete
• 页码：66-76
• 全文大小：1429 K

文摘

The prevalence rate of depression in primary care is high. Primary care providers serve as the initial point of contact for the majority of patients with depression, yet, approximately 50% of cases remain unrecognized. The under-diagnosis of depression may be further exacerbated in limited English-language proficient (LEP) populations. Language barriers may result in less discussion of patients' mental health needs and fewer referrals to mental health services, particularly given competing priorities of other medical conditions and providers' time pressures. Recent advances in Health Information Technology (HIT) may facilitate novel ways to screen for depression and other mental health disorders in LEP populations. The purpose of this paper is to describe the rationale and protocol of a clustered randomized controlled trial that will test the effectiveness of an HIT intervention that provides a multi-component approach to delivering culturally competent, mental health care in the primary care setting. The HIT intervention has four components: 1) web-based provider training, 2) multimedia electronic screening of depression and PTSD in the patients' primary language, 3) Computer generated risk assessment scores delivered directly to the provider, and 4) clinical decision support. The outcomes of the study include assessing the potential of the HIT intervention to improve screening rates, clinical detection, provider initiation of treatment, and patient outcomes for depression and post-traumatic stress disorder (PTSD) among LEP Cambodian refugees who experienced war atrocities and trauma during the Khmer Rouge. This technology has the potential to be adapted to any LEP population in order to facilitate mental health screening and treatment in the primary care setting.