A case report: implementing a nurse telecare program for treating depression in primary care.
The treatment of depression in primary care needs improvement. Previously, we reported that a nurse telecare intervention for treating depression in primary care clinics significantly improved treatment outcomes. The usefulness of nurse telecare, however, depends upon the feasibility of dissemination. In this report we describe nurse telecare and the steps required for implementation, and describe its dissemination in various settings. In addition to medication, which is managed by a primary care physician, the key elements of nurse telecare are focused behavioral activation, emotional support, patient education, promotion of treatment adherence, and monitoring of progress, delivered in ten brief telephone appointments over four months by primary care nurses. Support from key administrators and clinical champions is crucial to success. Nurses need "dedicated" scheduled time for telecare activities. Nurse telecare has been piloted and disseminated in diverse settings. The model required only small modifications for dissemination, and was implemented with minimal investment of resources and no negative impact on clinic operations.
Meresman
Joel F
JF
Department of Psychiatry, Kaiser Permanente Medical Care Program, Northern California Region, Santa Clara, CA 95051, USA. joel.f.meresman@kp.org
Hunkeler
Enid M
EM
Hargreaves
William A
WA
Kirsch
Arlene J
AJ
Robinson
Patricia
P
Green
Ann
A
Mann
Elvira Z
EZ
Getzell
Michael
M
Feigenbaum
Paul
P
D001521:Behavior Therapy; D003376:Counseling; D003866:Depressive Disorder / Q000188:drug therapy / Q000628:therapy*; D004502:Education, Medical, Continuing; D004506:Education, Nursing; D006801:Humans; D009726:Nurses / Q000458:organization & administration*; D010348:Patient Care Team; D011320:Primary Health Care / Q000458:organization & administration*; D019114:Remote Consultation; D014481:United States