TRIPPD: a practice-based network effectiveness study of postpartum depression screening and management
- PMID: 22778120
- PMCID: PMC3392291
- DOI: 10.1370/afm.1418
TRIPPD: a practice-based network effectiveness study of postpartum depression screening and management
Abstract
Purpose: Postpartum depression is common but inadequately recognized and undertreated. Continuing depressive symptoms are associated with adverse outcomes for the woman, her infant, and family. We wanted to determine the effect of a practice-based training program for screening, diagnosis, and management of depression in postpartum mothers.
Methods: In this practice-based effectiveness study, 28 practices were randomized to usual care (n = 14) or intervention (n = 14), and 2,343 women were enrolled between 5 and 12 weeks' postpartum. The intervention sites received education and tools for postpartum depression screening, diagnosis, initiation of therapy, and follow-up within their practices. Usual-care practices received a 30-minute presentation about postpartum depression. Screening information for the usual care was obtained from baseline surveys sent directly to the central site but was not available for patient care. Outcomes were based on patient-reported outcomes (level of depressive symptoms) from surveys at 6 and 12 months, plus medical record review (diagnosis and therapy initiation).
Results: Among the 2,343 women enrolled, 1,897 (80.1%) provided outcome information, and were included in the analysis. Overall, 654 (34.5% of 1,897) women had elevated screening scores indicative of depression, with comparable rates in the intervention and usual-care groups. Among the 654 women with elevated postpartum depression screening scores, those in the intervention practices were more likely to receive a diagnosis (P = .0006) and therapy for postpartum depression (P = .002). They also had lower depressive symptom levels at 6 (P = .07) and 12 months' (P=.001) postpartum.
Conclusions: Primary care-based screening, diagnosis, and management improved mother's depression outcomes at 12 months. This practical approach could be implemented widely with modest resources.
Figures
Comment in
-
A primary care-based treatment programme improves postpartum depression at 12 months.Evid Based Ment Health. 2013 Feb;16(1):6. doi: 10.1136/eb-2012-100976. Epub 2012 Oct 4. Evid Based Ment Health. 2013. PMID: 23038167 No abstract available.
-
Primary care-based screening, diagnosis and management of postpartum depression effective for improving symptoms.Evid Based Med. 2013 Jun;18(3):e27. doi: 10.1136/eb-2012-100972. Epub 2012 Oct 12. Evid Based Med. 2013. PMID: 23065772 No abstract available.
-
PURLs: Should you screen for postpartum depression?J Fam Pract. 2013 Nov;62(11):E1-3. J Fam Pract. 2013. PMID: 24288714 Free PMC article.
Similar articles
-
Evaluating universal education and screening for postpartum depression using population-based data.J Womens Health (Larchmt). 2014 Aug;23(8):657-63. doi: 10.1089/jwh.2013.4586. Epub 2014 Jul 29. J Womens Health (Larchmt). 2014. PMID: 25072299 Free PMC article.
-
Repeated depression screening during the first postpartum year.Ann Fam Med. 2015 May-Jun;13(3):228-34. doi: 10.1370/afm.1777. Ann Fam Med. 2015. PMID: 25964400 Free PMC article. Clinical Trial.
-
Suicidal Ideation.2022 May 2. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan–. 2022 May 2. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan–. PMID: 33351435 Free Books & Documents.
-
Depressive symptoms and access to mental health care in women screened for postpartum depression who lose health insurance coverage after delivery: findings from the Translating Research into Practice for Postpartum Depression (TRIPPD) effectiveness study.Mayo Clin Proc. 2014 Sep;89(9):1220-8. doi: 10.1016/j.mayocp.2014.05.011. Epub 2014 Aug 1. Mayo Clin Proc. 2014. PMID: 25091871 Clinical Trial.
-
[Postpartum psychological disorders: Screening and prevention after birth. Guidelines for clinical practice].J Gynecol Obstet Biol Reprod (Paris). 2015 Dec;44(10):1152-6. doi: 10.1016/j.jgyn.2015.09.016. Epub 2015 Oct 31. J Gynecol Obstet Biol Reprod (Paris). 2015. PMID: 26527020 Review. French.
Cited by 36 articles
-
Screening programs for common maternal mental health disorders among perinatal women: report of the systematic review of evidence.BMC Psychiatry. 2022 Jan 24;22(1):54. doi: 10.1186/s12888-022-03694-9. BMC Psychiatry. 2022. PMID: 35073867 Free PMC article. Review.
-
Scalable Screening and Treatment Response Monitoring for Perinatal Depression in Low- and Middle-Income Countries.Int J Environ Res Public Health. 2021 Jun 22;18(13):6693. doi: 10.3390/ijerph18136693. Int J Environ Res Public Health. 2021. PMID: 34206237 Free PMC article.
-
Prevalence and risk factors associated with postnatal depression in a South African primary care facility.Afr J Prim Health Care Fam Med. 2020 Nov 27;12(1):e1-e6. doi: 10.4102/phcfm.v12i1.2538. Afr J Prim Health Care Fam Med. 2020. PMID: 33354984 Free PMC article.
-
Towards an understanding of GPs' viewpoint on diagnosing postnatal depression in general practice: a small-scale realist evaluation.Prim Health Care Res Dev. 2020 Oct 9;21:e42. doi: 10.1017/S1463423620000316. Prim Health Care Res Dev. 2020. PMID: 33032675 Free PMC article.
-
Uptake of referrals for women with positive perinatal depression screening results and the effectiveness of interventions to increase uptake: a systematic review and meta-analysis.Epidemiol Psychiatr Sci. 2020 Jul 17;29:e143. doi: 10.1017/S2045796020000554. Epidemiol Psychiatr Sci. 2020. PMID: 32677601 Free PMC article.
Publication types
MeSH terms
Grant support
LinkOut - more resources
Full Text Sources
Medical