N/A Completed N=24 Randomized Single-blind Health Services Research

Participatory Design of Electronic Health Record Tools for Problem Solving Therapy

Depression

Source: ClinicalTrials.gov NCT03516513 ↗

Enrolled (actual)

Serious AEs

0.0%

Results posted

Aug 2024

Primary outcomePrimary: Acceptability of Intervention Measure — 4.13; 4.25; 3.69; 4.31 score on a scale — p=0.905

Summary

Problem Solving Therapy for Primary Care (PST-PC) is an evidence based psychosocial intervention (EBPI) for use in primary care settings, with more than 100 clinical trials. Despite its proven efficacy we have found that implementation of PST-PC is complicated, resulting in rapid program drift (deviation from protocol with associated loss of efficacy), among practitioners following completion of training. Many studied have shown that program drift is not uncommon in the implementation of EBPIs and can be mitigated through on-going decision support and supervision. Unfortunately, decision support and supervisors of EBPIs are not widely available in low-resourced primary care clinics. We will address this problem by creating decision support tools to be integrated into electronic health records. Because these tools are deemed by many practitioners in other fields to be burdensome, we will explicitly involve active input on the content, design and function of these support tools. Outcomes may include electronic dashboards for panel management, automated suggestions for application of PST-PC elements based on patient reported outcomes or integration of automated patient tracking, and support of patient engagement. We hypothesize that enhanced decision support (target mechanism) will sustain quality delivery of PST-PC, which in turn will improve patient reported outcomes.

Outcome Measures

Outcome	Result	p-value
PRIMARY Acceptability of Intervention Measure	4.13; 4.25; 3.69; 4.31	0.905
PRIMARY User Burden Scale	13.5; 5.8; 8.68; 8.53	.155
PRIMARY System Usability Scale	75.5; 66.25	—
SECONDARY Patient Health Questionnaire	13.75; 10.33	.212
SECONDARY Sheehan Disability Assessment Scale	15.25; 17.89	.507
SECONDARY Problem Solving Therapy Clinician Certification	1; 5	.091

Eligibility Criteria

Inclusion Criteria

Clinicians: 18 years of age, able to read and speak English, provides psychotherapy as part of the University of Washington Medicine network, and willing to video-record PST sessions with patient participants Clients: 18+ years of age, able to read and speak English, willing to receive psychotherapy from a clinician who is also participating in the study, willing to have therapy sessions video-recorded, Patient Health Questionnaire-9 score of 10 or higher

Exclusion Criteria

Client: History or presence of psychiatric diagnoses other than unipolar, non-psychotic depression or generalized anxiety disorder

View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT03516513). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication. Informational only — not medical advice.