title: Prevalence of practice system tools for improving depression care among primary care clinics: the DIAMOND initiative.
abstract: BACKGROUND
  Practice system tools improve chronic disease care, but are generally lacking for the care of depression in most primary care settings.
  
  
  OBJECTIVE
  To describe the frequency of various depression-related practice system tools among Minnesota primary care clinics interested in improving depression care.
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  Physician leaders of 82 clinics in Minnesota.
  
  
  METHODS
  A survey including practice systems recommended for care of depression and chronic conditions, each scored on a 100-point scale, and the clinic's priority for improving depression care on a 10-point scale.
  
  
  RESULTS
  Fewer practice systems tools were present and functioning well for depression care (score = 24.4 [SD 1.6]) than for the care of chronic conditions in general (score = 43.9 [SD 1.6]), p < 0.001. The average priority for improving depression care was 5.8 (SD 2.3). There was not a significant correlation between the presence of practice systems for depression or chronic disease care and the priority for depression care except for a modest correlation with the depression Decision Support subscale (r = 0.29, p = 0.008). Certain staffing patterns, a metropolitan-area clinic location, and the presence of a fully functional electronic medical record were associated with the presence of more practice system tools.
  
  
  CONCLUSIONS
  Few practice system tools are in place for improving depression care in Minnesota primary care clinics, and these are less well-developed than general chronic disease practice systems. Future research should focus on demonstrating whether implementing these tools for depression care results in much-needed improvements in care for patients with depression.
authors: HealthPartners Research Foundation, 8170 33rd Avenue South, Minneapolis, MN 55425, USA. karen.l.margolis@healthpartners.com
authors: Karen L
authors: KL
authors: Margolis
authors: Leif I
authors: LI
authors: Solberg
authors: A Lauren
authors: AL
authors: Crain
authors: Robin R
authors: RR
authors: Whitebird
authors: Kristin A
authors: KA
authors: Ohnsorg
authors: Nancy
authors: N
authors: Jaeckels
authors: Gary
authors: G
authors: Oftedahl
authors: Russell E
authors: RE
authors: Glasgow
references: Am J Manag Care. 2003 Feb;9(2):131-40
references: 12597601
references: Med Care. 2004 Dec;42(12):1222-9
references: 15550802
references: Cancer Pract. 1997 Nov-Dec;5(6):375-81
references: 9397706
references: JAMA. 2002 Oct 16;288(15):1909-14
references: 12377092
references: J Clin Psychol Med Settings. 2009 Mar;16(1):47-57
references: 19238525
references: Med Care. 2004 Dec;42(12):1202-10
references: 15550800
references: Am J Manag Care. 2007 Jun;13(6 Part 1):305-11
references: 17567228
references: Ann Intern Med. 2002 May 21;136(10):765-76
references: 12020146
references: Am J Manag Care. 2008 Feb;14(2):95-100
references: 18269305
references: Arch Intern Med. 2006 Nov 27;166(21):2314-21
references: 17130383
references: Qual Health Res. 2013 Jun;23(6):805-14
references: 23515301
references: Am J Med Qual. 2008 Nov-Dec;23(6):420-6
references: 19001099
references: Med Care. 2010 Jul;48(7):576-82
references: 20508531
references: J Fam Pract. 1997 Feb;44(2):193-202
references: 9040523
references: Gen Hosp Psychiatry. 2006 Mar-Apr;28(2):92-3
references: 16516057
references: Psychiatr Clin North Am. 2005 Dec;28(4):1079-92
references: 16325741
references: Pediatrics. 2001 Sep;108(3):E41
references: 11533359
references: Am J Prev Med. 2001 Jul;21(1):20-8
references: 11418253
references: Jt Comm J Qual Patient Saf. 2008 Jul;34(7):407-16
references: 18677872
references: Am J Manag Care. 2008 Feb;14(2):85-92
references: 18269304
references: Acad Med. 2009 Dec;84(12):1732-40
references: 19940582
references: JAMA. 2003 Jan 22-29;289(4):434-41
references: 12533122
references: Gen Hosp Psychiatry. 2007 Mar-Apr;29(2):91-116
references: 17336659
references: JAMA. 2002 Dec 11;288(22):2836-45
references: 12472325
references: Am J Manag Care. 2005 Dec;11(12):789-96
references: 16336063
references: N Engl J Med. 2003 Jun 26;348(26):2635-45
references: 12826639
references: J Am Board Fam Pract. 2005 Nov-Dec;18(6):520-7
references: 16322414
references: Ann Fam Med. 2004 Jul-Aug;2(4):294-300
references: 15335126