DARTNet Institute Informing Practice Improving Care
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Effect Rx: Integrating Patient-reported Outcomes and EHR Data to Improve Clinical Decision Support for Depression Treatment

This project will collect depression severity and side effect tolerability information from patients in primary care being treated with an antidepressant, and integrate this information into a feedback report for clinicians to use at the point-of-care. The overall goal is to increase medication adherence and improve depression treatment outcomes.

Specific Aim 1: Enhance an existing clinician feedback report by integrating novel data collected electronically from patients between clinical visits with medication adherence and EHR data; pilot test the data collection and enhanced report in eight eNQUIRENet primary care practices.

Specific Aim 2: Using semi-structured interviews with up to 12 patients and up to 8 clinicians who participate in Specific Aim 1, assess the feasibility and utility of the patient data collection and enhanced clinician feedback by obtaining: (1) patients’ reactions to completing the online surveys and the usefulness of their clinician receiving the information from those surveys; and (2) clinicians’ opinions regarding the feedback’s content, format, timing, and associated resource burden.

Funding

AHRQ Grant R21HS021769, Heather D. Anderson, PhD (PI), Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Denver

Dataset Description

The resulting dataset will include the following information, collected from participants at multiple times over a period of 3-6 months:

  • frequency, intensity, and burden of 6 groups of side effects (agitation, sedation, headache, gastrointestinal, sexual dysfunction, and other)
  • has patient filled their antidepressant
  • has the patient missed any doses of the antidepressant in the past 7 days
  • responses to all 9 items of the PHQ-9
  • responses to up to 2 additional suicide screeners (have feelings increased recently; does your doctor know)

The data in the table below will be extracted from eletronic health records.

Type of Patients Included N Data Elements
All patients ages 18 and older with at least one primary care visit at a participating site since 1/1/2009 n/a
  • Diagnoses
  • Prescribed Medications
  • Insurance
  • Visit information
  • Gender
  • Age
  • Date of birth
  • Practice type / department
  • Visit date
  • Race
  • Ethnicity
  • Height
  • Weight
  • Blood pressure
  • Level of service CPT code
  • Evaluation and Management billing codes
  • Zip code
  • Allergies
  • PHQ-9