Table 4.
Exposure to PIC Intervention Activities and Non-PIC Depression Practice Activities (at Follow-up) by Intervention Condition*
| Measure | N | QI-Meds | QI-Therapy | Usual Care | All | M&U | P&U | M&P | I&U |
|---|---|---|---|---|---|---|---|---|---|
| Exposure to PIC intervention activities | |||||||||
| Any participation in clinician education about depression, % in past year | |||||||||
| Individual sessions | 158 | 35.4 | 57.9 | 30.2 | .007† | .37 | .003† | .04† | .02† |
| Group seminars or grand rounds | 156 | 44.7 | 64.9 | 42.3 | .03† | .85 | .008† | .02† | .08† |
| Aware that clinic made changes or implemented programs to improve depression care, % | 155 | 31.9 | 35.7 | 13.5 | .02† | .01† | .001† | .54 | .002† |
| Knew how many patients were enrolled in PIC, % | 158 | 22.9 | 17.5 | 3.8 | .02† | .002† | .019† | .34 | .004† |
| Used practice resources for treating depression, % used “a little” or “a lot” in the last year | |||||||||
| Clinical practice guidelines or manuals | 159 | 69.4 | 66.7 | 54.7 | .26 | .25 | .22 | .98 | .16 |
| Feedback on patient outcomes | 159 | 71.4 | 73.7 | 62.3 | .40 | .53 | .30 | .71 | .32 |
| Nurse assessment and follow-up | 159 | 75.5 | 57.9 | 43.4 | .004† | <.001† | .066† | .05† | .002† |
| Patient education brochures or videotapes | 159 | 55.1 | 49.1 | 58.5 | .61 | .62 | .43 | .80 | .45 |
| Clinician education or training by local experts | 159 | 63.3 | 70.2 | 56.6 | .34 | .49 | .07† | .29 | .13 |
| Referral of depressed patients to mental health specialists | 159 | 95.9 | 96.5 | 94.3 | .61 | .74 | .59 | .86 | .60 |
| Exposure to non-PIC depression practice activities | |||||||||
| CME for depression, hours/past 3 years | 156 | 5.5 (7.3) | 4.7 (6.5) | 4.1 (4.5) | .56 | .86 | 1.00 | 1.00 | .38 |
| QA for mental health care, hours/past year | 160 | 4.3 (14.3) | 1.6 (5.0) | 1.9 (6.6) | .26 | .58 | 1.00 | .37 | .57 |
| Read articles about major depression, no. of times past/year | 157 | 5.7 (13.5) | 3.5 (4.4) | 4.2 (4.0) | .37 | 1.00 | 1.00 | .50 | .83 |
| Consulted a mental health specialist about treating depression, no. of times/past year | 157 | 6.8 (10.8) | 7.6 (13.4) | 4.3 (3.6) | .23 | .70 | .29 | 1.00 | .09† |
| Detailed by a pharmaceutical company about depression medication, no. of times/past year | 157 | 13.6 (13.4) | 9.1 (10.5) | 12.8 (16.4) | .18 | 1.00 | .47 | .26 | .48 |
| Preauthorization requests for referral to mental health specialty, no. of requests/past year | 153 | 7.9 (16.5) | 7.4 (10.8) | 12.5 (21.3) | .24 | .54 | .35 | 1.00 | .09† |
| Preauthorization requests for SSRI antidepressants, no. of requests/past year | 153 | 8.8 (20.3) | 12.3 (21.2) | 16.2 (23.4) | .27 | .30 | 1.00 | 1.00 | .15 |
*
N = 109 for multivariate models. Standard errors in parentheses for continuous variables only. Two-sided P values for χ2 test (for binary variables) or F-test (for continuous measures) comparing across all three intervention conditions shown in “All” column; 2-sided P values for pairwise comparisons shown in columns: M&U for QI-Meds vs usual care; P&U for QI-therapy vs usual care; M&P for QI-Meds vs QI-therapy; and I&U for interventions combined vs usual care.
†
P < .10.
PIC indicates Partners in Care; CME, continuing medication education; QA, quality assurance; SSRI, selective serotonin reuptake inhibitor.