Table 1

RCT Sub-studies and Process and Outcome Measures
Measurement points Method(s) of measurement
Immediately after index office visit 12 week follow-up
Sub-study 1: patientswithclinically significant depressive symptoms (baseline PHQ-9 ≥ 5)
   Process of care
     Key outcome - components of initial depression care (CIDC): antidepressant prescription and/or mental health referral among participants with baseline PHQ-9 ≥ 10* X PQ, PCPQ, MRR
       Antidepressant prescription and/or mental health referral among all sub-study participants* X
       Follow-up with PCP at an appropriate interval† X
       Inquiry regarding self-harm/suicidal thoughts X
   Patient function
     PHQ-8 score X X PQ
     SF-12 Mental Component Summary score X
     SF-12 Physical Component Summary score X
   Patient engagement in depression care
     Readiness PQ
       To discuss depression (in general) with PCP X
       To discuss depression treatment with PCP X
       For recognizing depression X X
       For discussing depression with PCP X X
     Provider-patient interaction PQ, PCPQ, MRR
       Discussion of depression X
       Patient request for depression treatment X
   Patient perceived depression stigma X X PQ
Sub-study 2: patientswithoutclinically significant depressive symptoms (baseline PHQ-9 < 5)
   Process of care
     Antidepressant prescription (over-treatment) X PQ, PCPQ, MRR
     Distraction effects
       Index office visit length X
       Patient request for depression treatment X
       Physician visit effort X
   Patient function
     SF-12 Physical Component Summary score (potential toxicity, i.e. reduced function) X PQ
     Patient perceived depression stigma (potential reduction) X X PQ

* Sub-study 1 primarily powered to examine this outcome; research evidence indicates PHQ-9 scores ≥ 10 are associated with significant life impairment (e.g. reduced functional abilities) and a strong likelihood of clinical depression, while scores of 5–9 are more equivocal in this regard.

Not an evidence-based element of care, but endorsed in prevailing clinical practice guidelines.

Includes all PHQ-9 items except the item concerning self-harm thoughts.


AMEP2, Activating Messages for Enhancing Primary Care Practice; MRR, medical record review; NA, not applicable (participants in this sub-study are not followed up); PCP, primary care provider; PCPQ, PCP questionnaire; PHQ, Patient Health Questionnaire; PQ, patient questionnaire.

Tancredi et al.

Tancredi et al. BMC Health Services Research 2013 13:141   doi:10.1186/1472-6963-13-141

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