Evaluation of the Achieving Depression and Anxiety Patient Centered Treatment (ADAPT) Program

Kaiser Permanente

Overview

Depression and anxiety are increasingly common conditions for which primary care providers (PCPs) serve as the initial healthcare contact for most patients. Comorbid depression and anxiety result in higher costs, and treatment as usual, which is referrals to specialty psychiatric care, often contribute to delays in care. Collaborative psychiatric care is an evidence-based strategy to increase mental healthcare access while reducing costs. ADAPT is a novel collaborative care model. By using technology-driven appointments with providers, ADAPT increases access to mental healthcare, and reduces member wait times. This mixed methods study will assess implementation measures of the ADAPT program and the components of ADAPT related to patient mental health improvement compared to specialty mental health care. The hypothesis is that: ADAPT program will have good program reach and efficacy. We will examine program implementation and maintenance. Further, the study looks to uncover member and program characteristics that are associated with depression and anxiety remission and care utilization.

Study Type

OBSERVATIONAL

Conditions

Depression Anxiety

Interventions

ADAPTBEHAVIORAL

The Achieving Depression and Anxiety Patient Centered Treatment (ADAPT) Program is a novel collaborative psychiatric care model that is designed to unburden PCPs and psychiatrists, increase access to quality specialty mental healthcare for Kaiser Permanente members, and improve patient depression and anxiety treatment outcomes by utilizing technology-driven appointments. This program uses principles of collaborative care, including patient-centered care, population-based care, evidence-based care, measurement-based treatment to target, and accountable care.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Adult Outcomes Questionnaire (AOQ) score between 10-30 * English-Speaking Exclusion Criteria: * High risk for suicide defined by answer to question 9 on PHQ-9 of 1 or more * Diagnosis of bipolar disorder * Diagnosis of a psychotic disorder * Dementia diagnosis * Active substance use disorder diagnosis * Current hospice * Current home-based palliative care * Residing in a skilled nursing facility * Residing in an assisted living facility * Non-Kaiser Permanente Member * Established psychiatric care outside of Kaiser Permanente

Locations (1)

Kaiser Permanente Northern California Division of Research

Oakland, California, United States

Outcomes

Primary Outcomes

Patient reach

Examine and compare patients eligible and enrolled in ADAPT versus those eligible but not enrolled in ADAPT

Time frame: through study completion, 2 years

Secondary Outcomes

Member characteristics associated with depression remission

Clinical variables important to predicting intervention response: Patient demographics (age, sex, race/ethnicity, socioeconomic status), behavioral characteristics (exercise, sleep), and other individual characteristics (comorbidities, adverse childhood experiences, social supports, resilience).