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The impact of evidence-based guideline dissemination for the assessment and treatment of major depression in a managed behavioral health care organization

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Abstract

This study tests whether a managed behavioral health care organization can influence adherence to practice guidelines for the treatment of major depression in a randomized trial of guideline dissemination. Guidelines were disseminated to mental health clinicians (N=443) under one of three conditions: (1) a general mailing of guidelines to clinicians, (2) a mailing in which guidelines were targeted to a patient starting treatment with the clinician, and (3) no mailing of guidelines. The results showed no effects of guideline dissemination as measured by self-report of patients and clinicians and through episode characteristics derived from claims data, despite sentinel effects. Results also showed high rates of clinician-reported guideline adherence that were not detected in the claims data, indicating significant undertreatment of depression. Results suggest that mental health systems must look to other dissemination strategies to improve adherence to standards of care and raise the performance of independent practicing clinicians

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Authors and Affiliations

  1. Behavioral Health Sciences Department, United Behavioral Health, 425 Market Street, 27th Floor, 94105, San Francisco, CA

    Francisca Azocar PhD (Research Scientist), Brian Cuffel PhD (Vice President of Research and Evaluation), William Goldman MD (Senior Vice President for Behavioral Health Sciences) & Loren McCarter PhD (Senior Research Analyst)

Authors
  1. Francisca Azocar PhD
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  2. Brian Cuffel PhD
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  3. William Goldman MD
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  4. Loren McCarter PhD
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Correspondence to Francisca Azocar PhD.

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Azocar, F., Cuffel, B., Goldman, W. et al. The impact of evidence-based guideline dissemination for the assessment and treatment of major depression in a managed behavioral health care organization. The Journal of Behavioral Health Services & Research 30, 109–118 (2003). https://doi.org/10.1007/BF02287816

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