Predictors and outcomes in primary depression care (POKAL) - a research training group develops an innovative approach to collaborative care.
Chronic care model (CCM)
Depression
Multimorbidity
Primary care
Research training group
Journal
BMC primary care
ISSN: 2731-4553
Titre abrégé: BMC Prim Care
Pays: England
ID NLM: 9918300889006676
Informations de publication
Date de publication:
02 12 2022
02 12 2022
Historique:
received:
03
05
2022
accepted:
15
11
2022
entrez:
2
12
2022
pubmed:
3
12
2022
medline:
7
12
2022
Statut:
epublish
Résumé
The interdisciplinary research training group (POKAL) aims to improve care for patients with depression and multimorbidity in primary care. POKAL includes nine projects within the framework of the Chronic Care Model (CCM). In addition, POKAL will train young (mental) health professionals in research competences within primary care settings. POKAL will address specific challenges in diagnosis (reliability of diagnosis, ignoring suicidal risks), in treatment (insufficient patient involvement, highly fragmented care and inappropriate long-time anti-depressive medication) and in implementation of innovations (insufficient guideline adherence, use of irrelevant patient outcomes, ignoring relevant context factors) in primary depression care. In 2021 POKAL started with a first group of 16 trainees in general practice (GPs), pharmacy, psychology, public health, informatics, etc. The program is scheduled for at least 6 years, so a second group of trainees starting in 2024 will also have three years of research-time. Experienced principal investigators (PIs) supervise all trainees in their specific projects. All projects refer to the CCM and focus on the diagnostic, therapeutic, and implementation challenges. The first cohort of the POKAL research training group will develop and test new depression-specific diagnostics (hermeneutical strategies, predicting models, screening for suicidal ideation), treatment (primary-care based psycho-education, modulating factors in depression monitoring, strategies of de-prescribing) and implementation in primary care (guideline implementation, use of patient-assessed data, identification of relevant context factors). Based on those results the second cohort of trainees and their PIs will run two major trials to proof innovations in primary care-based a) diagnostics and b) treatment for depression. The research and training programme POKAL aims to provide appropriate approaches for depression diagnosis and treatment in primary care.
Sections du résumé
BACKGROUND
The interdisciplinary research training group (POKAL) aims to improve care for patients with depression and multimorbidity in primary care. POKAL includes nine projects within the framework of the Chronic Care Model (CCM). In addition, POKAL will train young (mental) health professionals in research competences within primary care settings. POKAL will address specific challenges in diagnosis (reliability of diagnosis, ignoring suicidal risks), in treatment (insufficient patient involvement, highly fragmented care and inappropriate long-time anti-depressive medication) and in implementation of innovations (insufficient guideline adherence, use of irrelevant patient outcomes, ignoring relevant context factors) in primary depression care.
METHODS
In 2021 POKAL started with a first group of 16 trainees in general practice (GPs), pharmacy, psychology, public health, informatics, etc. The program is scheduled for at least 6 years, so a second group of trainees starting in 2024 will also have three years of research-time. Experienced principal investigators (PIs) supervise all trainees in their specific projects. All projects refer to the CCM and focus on the diagnostic, therapeutic, and implementation challenges.
RESULTS
The first cohort of the POKAL research training group will develop and test new depression-specific diagnostics (hermeneutical strategies, predicting models, screening for suicidal ideation), treatment (primary-care based psycho-education, modulating factors in depression monitoring, strategies of de-prescribing) and implementation in primary care (guideline implementation, use of patient-assessed data, identification of relevant context factors). Based on those results the second cohort of trainees and their PIs will run two major trials to proof innovations in primary care-based a) diagnostics and b) treatment for depression.
CONCLUSION
The research and training programme POKAL aims to provide appropriate approaches for depression diagnosis and treatment in primary care.
Identifiants
pubmed: 36460965
doi: 10.1186/s12875-022-01913-6
pii: 10.1186/s12875-022-01913-6
pmc: PMC9717547
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
309Subventions
Organisme : Deutsche Forschungsgemeinschaft
ID : DFG - GrK 2621 / POKAL-Kolleg
Investigateurs
Hannah Schillock
(H)
Regina Wehrstedt von Nessen-Lapp
(RW)
Kirsten Lochbühler
(K)
Informations de copyright
© 2022. The Author(s).
Références
J Gen Intern Med. 2016 Oct;31(10):1206-11
pubmed: 27170304
Lancet. 2007 Sep 8;370(9590):851-8
pubmed: 17826170
Psychosom Med. 2002 Mar-Apr;64(2):258-66
pubmed: 11914441
Sci Rep. 2022 Jan 7;12(1):272
pubmed: 34997129
BMJ. 2019 Apr 8;365:l835
pubmed: 30962249
BMC Psychiatry. 2013 Oct 14;13:260
pubmed: 24125027
J Occup Environ Med. 2008 Apr;50(4):451-8
pubmed: 18404018
Psychiatr Clin North Am. 2020 Sep;43(3):501-510
pubmed: 32773077
Health Aff (Millwood). 2020 Nov;39(11):1943-1950
pubmed: 33136506
JAMA. 2010 Jan 6;303(1):47-53
pubmed: 20051569
Am J Manag Care. 2012 Feb 01;18(2):e55-60
pubmed: 22435885
J Affect Disord. 2012 Oct;142 Suppl:S8-21
pubmed: 23062861
Lancet. 2012 Jul 7;380(9836):37-43
pubmed: 22579043
BMJ. 2001 Oct 27;323(7319):948-9
pubmed: 11679372
J Affect Disord. 2021 Nov 1;294:391-409
pubmed: 34315101
BMJ. 2019 Apr 8;365:l794
pubmed: 30962184
Med Hypotheses. 2007;68(3):683-91
pubmed: 17140747
Crit Care Med. 2001 Jul;29(7):1303-10
pubmed: 11445675
Health Aff (Millwood). 2009 Jan-Feb;28(1):75-85
pubmed: 19124857
Int J Environ Res Public Health. 2021 Mar 13;18(6):
pubmed: 33805664
Z Evid Fortbild Qual Gesundhwes. 2019 Nov;147-148:20-27
pubmed: 31623979
Health Econ Rev. 2022 Feb 12;12(1):14
pubmed: 35150372
Value Health. 2016 Sep - Oct;19(6):892-902
pubmed: 27712719
Med Care. 2019 Oct;57 Suppl 10 Suppl 3:S221-S227
pubmed: 31517791
BMC Fam Pract. 2011 Sep 22;12:98
pubmed: 21939542
J Affect Disord. 2016 Jan 1;189:379-91
pubmed: 26476422
Public Health Rev. 2012 Jan 1;34(1):71-83
pubmed: 24532867
Age Ageing. 2013 Jan;42(1):62-9
pubmed: 22910303
J Psychiatr Ment Health Nurs. 2007 May;14(3):233-8
pubmed: 17430445
J Psychosom Res. 2017 Jun;97:131-135
pubmed: 28606493
J Psychosom Res. 2013 Jan;74(1):82-5
pubmed: 23272993
BMC Health Serv Res. 2015 May 10;15:194
pubmed: 25958128
Med Care. 2005 May;43(5):436-44
pubmed: 15838407
J Psychosom Res. 2020 Nov;138:110257
pubmed: 32992210
Health Aff (Millwood). 2001 Nov-Dec;20(6):64-78
pubmed: 11816692
Med Care. 2009 Sep;47(9):959-67
pubmed: 19704353
MMW Fortschr Med. 2021 Dec;163(Suppl 6):9-18
pubmed: 34817784
J Affect Disord. 2017 Feb;209:80-85
pubmed: 27888724
JAMA Psychiatry. 2020 Jan 1;77(1):96-98
pubmed: 31577340
Implement Sci. 2015 Apr 21;10:54
pubmed: 25895908
Can J Psychiatry. 2017 Nov;62(11):761-771
pubmed: 28718325
Diabetes Care. 2005 Nov;28(11):2655-61
pubmed: 16249535
BMC Psychiatry. 2020 Mar 30;20(1):142
pubmed: 32228541
Psychogeriatrics. 2011 Dec;11(4):227-34
pubmed: 22151242
Intensive Care Med. 2007 Apr;33(4):606-18
pubmed: 17323051
BMJ. 2015 Mar 11;350:h949
pubmed: 25762567
Soc Psychiatry Psychiatr Epidemiol. 2012 Feb;47(2):175-84
pubmed: 21184214
BMJ Open. 2013 Sep 13;3(9):e003610
pubmed: 24038011
Lancet. 2009 Aug 22;374(9690):609-19
pubmed: 19640579
Chronic Illn. 2009 Dec;5(4):268-76
pubmed: 19933249
Med Care. 2008 Mar;46(3):266-74
pubmed: 18388841
Int J Ment Health Nurs. 2012 Dec;21(6):513-23
pubmed: 22640276
Diagn Progn Res. 2019 Aug 22;3:16
pubmed: 31463368
Arch Intern Med. 2007 Mar 26;167(6):551-61
pubmed: 17389286
Can J Psychiatry. 2005 Mar;50(4):195-202
pubmed: 15898458
Ann Intern Med. 2009 Sep 15;151(6):369-78
pubmed: 19755362
Implement Sci. 2017 Nov 22;12(1):139
pubmed: 29166911
BMC Med. 2015 Apr 07;13:74
pubmed: 25889849
Depress Anxiety. 2006;23(5):312-24
pubmed: 16688730
Scand J Prim Health Care. 2013 Mar;31(1):43-9
pubmed: 23281962
Z Arztl Fortbild Qualitatssich. 2006;100(5):365-74
pubmed: 16955622
JAMA. 2002 Dec 11;288(22):2836-45
pubmed: 12472325
Am J Psychiatry. 2012 Aug;169(8):790-804
pubmed: 22772364
Implement Sci. 2018 Jul 26;13(1):98
pubmed: 30045735
BMC Health Serv Res. 2009 Aug 11;9:145
pubmed: 19671164
Health Policy. 2018 Jan;122(1):23-35
pubmed: 29031933
J Gen Intern Med. 2001 Sep;16(9):606-13
pubmed: 11556941
Front Psychiatry. 2020 Mar 06;11:74
pubmed: 32210846
Z Arztl Fortbild Qualitatssich. 2005 Feb;99(1):57-63
pubmed: 15804131
Cochrane Database Syst Rev. 2012 Oct 17;10:CD006525
pubmed: 23076925
J Med Internet Res. 2021 Mar 24;23(3):e24387
pubmed: 33759801
Lancet Reg Health Eur. 2021 Jul;6:100152
pubmed: 34226894
BMJ. 2013 Jun 05;346:f2570
pubmed: 23738992
Int J Environ Res Public Health. 2019 Dec 11;16(24):
pubmed: 31835691
PLoS One. 2014 Jul 21;9(7):e102149
pubmed: 25048354