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. 2023 May 5;12(9):3297.
doi: 10.3390/jcm12093297.

Assessment and Monitoring of the Quality of Clinical Pathways in Patients with Depressive Disorders: Results from a Multiregional Italian Investigation on Mental Health Care Quality (the QUADIM Project)

Matteo Monzio Compagnoni  1   2 , Giulia Caggiu  1   2   3 , Liliana Allevi  3 , Angelo Barbato  4 , Flavia Carle  2   5 , Barbara D'Avanzo  4 , Teresa Di Fiandra  6 , Lucia Ferrara  7 , Andrea Gaddini  8 , Cristina Giordani  9 , Michele Sanza  10 , Alessio Saponaro  11 , Salvatore Scondotto  2   12 , Valeria D Tozzi  7 , Giovanni Corrao  1   2 , Antonio Lora  2   3   13
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Assessment and Monitoring of the Quality of Clinical Pathways in Patients with Depressive Disorders: Results from a Multiregional Italian Investigation on Mental Health Care Quality (the QUADIM Project)

Matteo Monzio Compagnoni et al. J Clin Med. .

Abstract

Ensuring adequate quality of care to patients with severe mental disorders remains a challenge. The implementation of clinical indicators aimed at assessing the quality of health care pathways delivered is crucial for the improvement of mental health services (MHS). This study aims to evaluate the quality of care delivered to patients who are taken-into-care with depressive disorders by MHS. Thirty-four clinical indicators concerning accessibility, appropriateness, continuity, and safety were estimated using health care utilization databases from four Italian regions (Lombardy, Emilia-Romagna, Lazio, Sicily). A total of 78,924 prevalent patients treated for depressive disorders in 2015 were identified, of whom 15,234 were newly engaged by MHS. During the year of follow-up, access to psychotherapeutic interventions was low, while the intensity was adequate; 5.1% of prevalent patients received at least one hospitalization in a psychiatric ward (GHPW), and 3.3% in the cohort of newly engaged in services. Five-out-of-10 patients had contact with community services within 14 days after GHPW discharge, but less than half of patients were persistent to antidepressant drug therapy. Furthermore, prevalent patients showed an excess of mortality compared to the general population (SMR = 1.35; IC 95%: 1.26-1.44). In conclusion, the quality of health care is not delivered in accordance with evidence-based mental health standards. Evaluation of health interventions are fundamental strategies for improving the quality and equity of health care.

Keywords: assessment; clinical pathways; depressive disorders; health care research; health care utilization databases; mental health care; mental health services; monitoring; public health; quality of care.

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Conflict of interest statement

Corrao G. received research support from the European Community (EC), the Italian Agency of Drug (AIFA), and the Italian Ministry for University and Research (MIUR). He took part to a variety of projects that were funded by pharmaceutical companies (i.e., Novartis, GSK, Roche, AMGEN and BMS). He also received honoraria as member of Advisory Board from Roche. AL was employed by ASST Lecco. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow-chart of the inclusion and exclusion criteria for the eligibility of patients newly admitted to services with depressive disorders in the four regions (Lombardy, Emilia-Romagna, Sicily, and Lazio), and in the whole Italian sample. QUADIM-MAP Projects, Italy, 2015–2016.
See this image and copyright information in PMC

References

    1. Blazer D.G. Depression in Late Life: Review and Commentary. J. Gerontol. Ser. A. 2003;58:M249–M265. doi: 10.1093/gerona/58.3.M249. - DOI - PubMed
    1. Blazer D.G., Hybels C.F., Pieper C.F. The Association of Depression and Mortality in Elderly Persons: A Case for Multiple, Independent Pathways. J. Gerontol. Ser. A. 2001;56:M505–M509. doi: 10.1093/gerona/56.8.M505. - DOI - PubMed
    1. IsHak W.W., Greenberg J.M., Balayan K., Kapitanski N., Jeffrey J., Fathy H., Fakhry H., Rapaport M.H. Quality of Life: The Ultimate Outcome Measure of Interventions in Major Depressive Disorder. Harv. Rev. Psychiatry. 2011;19:229–239. doi: 10.3109/10673229.2011.614099. - DOI - PubMed
    1. Papakostas G.I., Petersen T., Mahal Y., Mischoulon D., Nierenberg A.A., Fava M. Quality of Life Assessments in Major Depressive Disorder: A Review of the Literature. Gen. Hosp. Psychiatry. 2004;26:13–17. doi: 10.1016/j.genhosppsych.2003.07.004. - DOI - PubMed
    1. McCarron R.M., Shapiro B., Rawles J., Luo J. Depression. Ann. Intern. Med. 2021;174:ITC65–ITC80. doi: 10.7326/AITC202105180. - DOI - PubMed

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