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Top 30 Quality Measures

Weekly Contact for Severe Depression Overall Rank: 14
Frequency of contact for people with major depression should be weekly for severe depressive symptoms; every 2-4 weeks if mild or moderate symptoms are present.
Domain : Patients with Mood Disorders
Any of several psychological disorders characterized by abnormal emotional states and including especially major depressive disorder and bipolar disorder. Also called affective disorder.
Additional Domain(s) : Continuity, Patient-Centeredness
Rationale
Improving attitudes toward antidepressant medications along with the patients ability to handle medications side-effects and key factors in promoting greater adherence to maintenance treatment and thus greater likelihood of preventing relapse. Interventions toward this end may include patient visits with a depression prevention specialist (PhD, MSN, MSW who has received special training) and follow-up phone calls. Interventions are critical to educating the patients regarding the importance of preventing relapse, safety and efficacy of medications and management of potential side effects.

The prevention of relapse is of primary importance in the treatment of major depression. From 50 to 85% of people who suffer an episode of major depression will have a recurrence, usually within two or three years. Patients who have had three or more episodes of major depression are at 90% risk of having another episode. Cognitive Behavioral Therapy and Interpersonal Therapy help protect against/prevent relapse.
Primary Reference
Major Depression in Adults in Primary Care. May 2004, Institute for Clinical Systems Improvement. P: 22 Retrieved Aug 3, 2006 from: http://www.icsi.org/knowledge/detail.asp? catID=29 &itemID=180
Level of Evidence
I: Consistently higher quality studies specifically focused on primary mental health care.

Summarized CommentsAdd Comment
  • Relevance increases if there are no other follow-up services or contacts.
  • Suggest a frequency of every 2-4 weeks until treatment efficacy is achieved, thereafter 2 months apart is acceptable
  • This could include telephone contact.
Variation in Results
Ratings-based Rank
Relevance 27
Actionability 11
Overall Importance 16
 
Stakeholder Rank
Academics 17
Clinicians 22
Consumers 9
Decision Makers 18
 
Special Group Rank
First Nations 7
Rural Areas 14
Federal Stakeholders 2
Regional Rank
BC AB SK MB ON QC NB NS PE NL YT NT NU
52 41 44 29 17 18 15 2 56 6 84 32 5
 
Overall Rank

      

14


SA10e (B641)

 
Distribution of Survey Respondent Ratings
Relevance
100
90
80
70
60
50
40
30
20
10
0
0.53 0.53 0.35 0.53 0.53 4.31 15.4 45.61 32.19
1 2 3 4 5 6 7 8 9
Low High
Actionability
100
90
80
70
60
50
40
30
20
10
0
0.53 0.53 1.07 1.39 3.41 3.87 14.76 44.87 29.56
1 2 3 4 5 6 7 8 9
Low High
Overall Importance
100
90
80
70
60
50
40
30
20
10
0
1.25 11.9 86.85
3 2 1

3 = can live without
2 = nice to have
1 = indispensable

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The views expressed herein do not necessarily represent the official policies of Health Canada