Evidence-based best practice model clinical pathways for people with co-morbod depression and coronary heart disease
Dunbar, James and Reddy, Prasuna 2006, Evidence-based best practice model clinical pathways for people with co-morbod depression and coronary heart disease, Greater Health - Greater Green Triangle, Burwood, Vic..
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Evidence-based best practice model clinical pathways for people with co-morbod depression and coronary heart disease
Contents 1. Literature Review...............................4 1.1 Incidence and prevalence of co-morbid depression and heart disease in Australia and internationally......4 1.2 Impact of depression on CHD progression and outcomes........6 1.3 Effectiveness of treating depression and outcomes of depression 9 1.4 Current studies in development, implementation and evaluation of clinical pathways co-morbid depression and other illnesses..............11 2. Methodology........14 2.1 Identifying current activities in Australia and overseas in relation to the development and implementation of clinical pathways for depression and CHD and other co-morbid chronic illness..14 2.2 Gaining management commitment from participating organisations..14 2.3 Creating a Clinical Pathways Team, Scoping the Pathway and Developing Process maps......14 2.4 Discovery Interviews with patients and carers...15 2.5 Health Provider and GP Interviews......16 2.6 Identifying best practice model clinical pathways for specific patient groups.....16 2.7 Pilot implementation of screening for depression...17 3. Results; Phase I : Clinical Pathways Process.......18 3.1 Information from Patient Interviews (Time 1)..18 3.2 Information from Patient Interviews (Time 2).........30 3.3 Information from Primary Support Person (Time 1)...38 3.4 Information from Primary Support Person (Time 2)...43 3.5 Information from Health Professional and GP Interviews..46 4. Results; Phase II : Pilot implementation...52 4.1 Screening scores at T1......................52 4.2 Screening scores at T2...52 4.3 Information from rehabilitation nurses.........56 4.4 Information from GPs..........60 5. Discussion.....62 6. Recommendations....64 7. Conclusions.............66 8. References...67 Appendices.....75 Prepared for the National Heart Foundation of Australia (NHFA), 2006
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