Using Measurement-Based Care to Inform Antidepressant Medication Management Among Veterans: A Pilot Study

Abstract

OBJECTIVE: This pilot study examined the effectiveness of high and low measurement-based care (MBC) feedback strategies for depression treatment. METHODS: Twenty providers at a U.S. Department of Veterans Affairs facility were randomly assigned to a no-feedback, low-feedback (automated collection and scoring of a depression self-report measure), or high-feedback (automated collection and scoring plus automated decision support) condition. Patients (N=336) completed the electronic version of the Patient Health Questionnaire-9 biweekly for 16 weeks. Outcomes included number of medication changes and depression symptom severity. RESULTS: Patients completed 75% of the assessments. No statistically significant differences in medication changes or depression symptom severity were observed by condition. Approximately 46% of the patients received a medication change. The MBC groups had lower variability in management compared with the control group. Depression symptoms improved among all patients. CONCLUSIONS: MBC may reduce variability in medication management; however, automated collection was insufficient. Further research is needed to support implementation of all components of MBC.