Patient Self-Management in the Primary Care Treatment of Depression |
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| Authors: | John Bachman Sara Swenson M. Elizabeth Reardon Doriane Miller |
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| Affiliation: | (1) Communication Consultant, Robert Wood Johnson Foundation’s “Depression in Primary Care”, National Program Office, San Francisco, CA, USA;(2) Robert Wood Johnson Foundation’s “Depression in Primary Care” initiative and a research fellow in the Division of General Internal Medicine, University of California, San Francisco, CA, USA;(3) Office of Vermont Health Access, Williston, VT 05495, USA;(4) The Robert Wood Johnson Foundation’s national program on the Co-Management Learning Network and Senior Director for Quality and Clinical Research at the Health Research and Educational Trust, American Hospital Association, San Francisco, CA, USA |
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| Abstract: | Efforts to improve primary care treatment of depression incorporate elements of the chronic illness care model, including patient self-management strategies. Case studies, focus groups and the literature suggest six key components of depression self-management programs: (1) implement behavioral change interventions, (2) plan for crisis and relapse prevention, (3) re-establish personal meaning, (4) attend to patients’ experience, context and community, (5) build a patient–clinician partnership and (6) create an integrated, self-management support structure. Successful implementation of these components is facilitated by (1) the care system’s collective and empathic understanding of the disease itself; (2) sufficient time; (3) adequate funding and (4) robust clinical information systems. |
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| Keywords: | depression primary care patient activation self-management |
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