Clinician Note: Some of you may already be familiar with the recent research (Yawn, BP et al. TRIPPD: A practice-based network effectiveness study of postpartum depression screening and management. Ann Fam Med 2012) which set out to determine the effectiveness of “usual care” vs an intervention, consisting of screening and PPD management.
Usual-care practices received a 30-minute presentation about postpartum depression.
The intervention practices included education and staff training with regard to screening tools, diagnosis, and treatment options including medication, counseling and referrals. All 1897 women seen were in family medicine practices across the U.S.
Overall, 34.5% of the women had elevated depression screening scores, with similar rates for the intervention and usual-care groups. However, of those 654 women, the ones in the intervention practices were more likely to receive a diagnosis of PPD. Women in the intervention group also showed improvement in symptoms at 6 months and at 1 year.
Although there is nothing conclusive about these results, they do have important implications for clinicians according to Allison Bryant, MD, contributor to Journal Watch, The New England Journal of Medicine. For those of you who are marketing your clinical practice, it is vital that all health providers and clinicians who work with women consider these implications whether in family medicine, obstetrics, pediatrics, psychiatry.
The “usual care” of family practice is not sufficient. It is likely that if primary care practices implemented basic intervention programs, depression outcomes will improve. Moreover, this study provides a model for improving outcomes when integrating mental health and primary care practice.
This is precisely the information that healthcare providers need.