None listed
Conditions
Brief summary
Perinatal depression is highly prevalent (up to 20% of postnatal women experience depression meeting diagnostic criteria). The single largest barrier to treatment is the very low rate of initial identification, most cases go undetected (60% or more). Importantly, even when women are identified as depressed, only 10% receive adequate treatment. A major obstacle is that primary care professionals are generally time poor and lack simple integrated systems to assist them to not only detect depressed women, but also to make best-practice decisions about management. We have developed an electronic Clinical Decision Support System to guide health professionals (PIRIMID) to improve current practices through consistent, accurate and rapid assessment integrated with recommendations for pathways to care, based on NHMRC-endorsed Clinical Guidelines. Aim of This Study: To establish the effectiveness and cost-effectiveness of PIRIMID for identifying perinatal depression and facilitating treatment uptake compared to current practice.
Interventions
PIRIMID. Maternal and child health nurses (MCHNs) in this condition will use the integrated electronic screening and clinical decision support system (CDSS) to screen woman as part of their emotional health assessment during her 8-week Key Ages and Stages (KAS) visit at the Maternal and Child Health Centre.
The PIRIMID system is a tablet-based electronic screening system for carrying out perinatal depression screening and providing clinical decision support to health professionals. In the PIRIM
PIRIMID. Maternal and child health nurses (MCHNs) in this condition will use the integrated electronic screening and clinical decision support system (CDSS) to screen woman as part of their emotional health assessment during her 8-week Key Ages and Stages (KAS) visit at the Maternal and Child Health Centre. The PIRIMID system is a tablet-based electronic screening system for carrying out perinatal depression screening and providing clinical decision support to health professionals. In the PIRIMID system, the Edinburgh Postnatal Depression Scale (EPDS) score and other psychosocial information collected via e-screening are automatically collated and made available on the clinician's desktop in the form of an interactive dashboard. PIRIMID then provides clear, best-practice prompts to encourage clinicians to develop a management plan. PIRIMID guides the clinician with clear, step-by-step guidance, supporting information and prompts for structuring a management plan with referral decisions tailored to each woman's data. Screening will take approx 10 minutes, this includes 2-5 minutes of the woman answering questions by herself, and 5 minute of the clinician reviewing and discussing these responses with the woman. Women will then complete a study questionnaire which will take approx 10 minutes.
Sponsors
Professor Jeannette Milgrom
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Diagnosis
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
Ability to understand spoken and written English language Baby aged 6-10 weeks
Exclusion criteria
Nil
Outcome results
None listed