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    Using Mixed Methods to Examine the Role of Veterans' Illness Perceptions on Depression Treatment Utilization and HEDIS Concordance

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    Authors
    Elwy, A. Rani
    Glickman, Mark E.
    Bokhour, Barbara G.
    Dell, Natalie S.
    Mueller, Nora M.
    Zhao, Shibei
    Osei-Bonsu, Princess E.
    Rodrigues, Stephanie
    Coldwell, Craig M.
    Ngo, Tu A.
    Schlosser, James
    Vielhauer, Melanie J.
    Pirraglia, Paul A.
    Eisen, Susan V.
    Show allShow less
    UMass Chan Affiliations
    Department of Psychiatry
    Document Type
    Journal Article
    Publication Date
    2016-06-01
    Keywords
    Mental Disorders
    Psychology
    
    Metadata
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    Link to Full Text
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4257901/
    Abstract
    BACKGROUND: Although depression screening occurs annually in the Department of Veterans Affairs (VA) primary care, many veterans may not be receiving guideline-concordant depression treatment. OBJECTIVES: To determine whether veterans' illness perceptions of depression may be serving as barriers to guideline-concordant treatment. RESEARCH DESIGN: We used a prospective, observational design involving a mailed questionnaire and chart review data collection to assess depression treatment utilization and concordance with Healthcare Effectiveness Data and Information Set guidelines adopted by the VA. The Self-Regulation Model of Illness Behavior guided the study. SUBJECTS: Veterans who screened positive for a new episode of depression at 3 VA primary care clinics in the US northeast. MEASURES: The Illness Perceptions Questionnaire-Revised, measuring patients' perceptions of their symptoms, cause, timeline, consequences, cure or controllability, and coherence of depression and its symptoms, was our primary measure to calculate veterans' illness perceptions. Treatment utilization was assessed 3 months after the positive depression screen through chart review. Healthcare Effectiveness Data and Information Set (HEDIS) guideline-concordant treatment was determined according to a checklist created for the study. RESULTS: A total of 839 veterans screened positive for a new episode of depression from May 2009-June 2011; 275 (32.8%) completed the survey. Ninety-two (33.9%) received HEDIS guideline-concordant depression treatment. Veterans' illness perceptions of their symptoms, cause, timeline, and controllability of depression predicted receiving guideline-concordant treatment. CONCLUSIONS: Many veterans are not receiving guideline-concordant treatment for depression. HEDIS guideline measures may not be assessing all aspects of quality depression care. Conversations about veterans' illness perceptions and their specific needs are encouraged to ensure that appropriate treatment is achieved.
    Source
    Med Care. 2016 Jun;54(6):e35-42. doi: 10.1097/MLR.0000000000000056. Link to article on publisher's site
    DOI
    10.1097/MLR.0000000000000056
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/40016
    PubMed ID
    24374425
    Related Resources
    Link to Article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.1097/MLR.0000000000000056
    Scopus Count
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    UMass Chan Faculty and Researcher Publications

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