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A primary care-based treatment programme improves postpartum depression at 12 months

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Question: How effective is a practice-based programme for screening, diagnosing and managing depression in postpartum mothers?

Patients: A total of 2343 women between 5 and 12 weeks postpartum from 28 eligible primary care practices. The women had to be at least 18 years, speak English or Spanish and have been receiving continuing care at the family medical practice where they were enrolled. Eligible practices had to have provided maternity or well-baby care services to more than 30 individuals in the year prior to the study and not have been routinely screening for postpartum depression.

Setting: Twenty-eight family medicine practices, USA; March 2006–August 2010.

Intervention: A practice-wide intervention consisting of postpartum depression screening, diagnosis, evaluation and management. Intervention sites received training on postpartum depression screening and diagnosis using the Edinburgh Postnatal Depression Scale (EPDS) and the nine-item Patient Health Questionnaire PHQ-9, as well as training and practice of nursing telephone calls. Intervention practices were given tools containing an outline for follow-up visits and written materials for nursing follow-up phone calls related to medication and side effects. Usual care (control) sites continued to provide the …

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