TY - JOUR
KW - Accessibility
KW - Care manager
KW - collaborative care
KW - Continuity
KW - Depression
KW - Facilitator
KW - Primary Health Care
KW - Process evaluation
AU - I. Svenningsson
AU - E. L. Petersson
AU - C. Udo
AU - J. Westman
AU - C. Bjorkelund
AU - L. Wallin
A1 - 
AB - BACKGROUND: The collaborative care model with a care manager has previously generated beneficial results for patients with depression in terms of decreased burden of depression symptoms. A care manager function has been tested in Sweden in the PRIM-CARE RCT with successful results. The aim of the present study was to evaluate the process of implementing care managers in collaborative care for patients with depression in Swedish primary health care in the PRIM-CARE RCT. METHODS: The study followed UK Medical Research Council guidance for process evaluation. Field notes from the implementation of the PRIM - CARE RCT were used, as well as data collected from five focus group discussions with General Practitioners (n = 29) and three focus group discussions with care managers (n = 11). Data were analysed with content analysis. RESULTS: Training sessions, careful preparation and extensive initial support to the care manager and staff at the Primary Care Centres were important ingredients in the implementation. The close access to facilitators, the recurrent peer support meetings, and the weekly newsletter strengthened the care manager function. CONCLUSIONS: A complex intervention adapted to the Swedish primary care context focusing on a care manager function for patients with depression could be performed through a stepwise implementation process. Financial support from the health care regions included in the study helped to reduce the impact of identified barriers. This process evaluation has revealed new and important knowledge for primary care development concerning infrastructure and organization building, knowledge sharing, and facilitating factors and barriers. TRIAL REGISTRATION: NCT02378272 Care Manager - Coordinating Care for Person Centered Management of Depression in Primary Care (PRIM - CARE). Registered March 4 2015. Retrospectively registered.
AD - Department of Primary Health Care, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. irene.svenningsson@vgregion.se.; Region Vastra Gotaland, Narhalsan Research and Development Primary Health Care, Gothenburg, Sweden. irene.svenningsson@vgregion.se.; Department of Primary Health Care, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.; Region Vastra Gotaland, Narhalsan Research and Development Primary Health Care, Gothenburg, Sweden.; School of Education, Health and Social Studies, Dalarna University, Falun, Sweden.; Center for Clinical Research, Dalarna, Sweden.; Department of Health Care Sciences, Palliative Research Centre, Ersta Skondal Bracke University College, Stockholm, Sweden.; Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.; Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden.; Department of Primary Health Care, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.; Region Vastra Gotaland, Narhalsan Research and Development Primary Health Care, Gothenburg, Sweden.; School of Education, Health and Social Studies, Dalarna University, Falun, Sweden.; Center for Clinical Research, Dalarna, Sweden.; Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden.; Department of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
BT - BMC family practice
C5 - General Literature
CP - 1
CY - England
DO - 10.1186/s12875-019-0998-4
IS - 1
JF - BMC family practice
M1 - Journal Article
N2 - BACKGROUND: The collaborative care model with a care manager has previously generated beneficial results for patients with depression in terms of decreased burden of depression symptoms. A care manager function has been tested in Sweden in the PRIM-CARE RCT with successful results. The aim of the present study was to evaluate the process of implementing care managers in collaborative care for patients with depression in Swedish primary health care in the PRIM-CARE RCT. METHODS: The study followed UK Medical Research Council guidance for process evaluation. Field notes from the implementation of the PRIM - CARE RCT were used, as well as data collected from five focus group discussions with General Practitioners (n = 29) and three focus group discussions with care managers (n = 11). Data were analysed with content analysis. RESULTS: Training sessions, careful preparation and extensive initial support to the care manager and staff at the Primary Care Centres were important ingredients in the implementation. The close access to facilitators, the recurrent peer support meetings, and the weekly newsletter strengthened the care manager function. CONCLUSIONS: A complex intervention adapted to the Swedish primary care context focusing on a care manager function for patients with depression could be performed through a stepwise implementation process. Financial support from the health care regions included in the study helped to reduce the impact of identified barriers. This process evaluation has revealed new and important knowledge for primary care development concerning infrastructure and organization building, knowledge sharing, and facilitating factors and barriers. TRIAL REGISTRATION: NCT02378272 Care Manager - Coordinating Care for Person Centered Management of Depression in Primary Care (PRIM - CARE). Registered March 4 2015. Retrospectively registered.
PP - England
PY - 2019
SN - 1471-2296; 1471-2296
SP - 019
EP - 4
EP - 108+
T1 - Process evaluation of a cluster randomised intervention in Swedish primary care: using care managers in collaborative care to improve care quality for patients with depression
T2 - BMC family practice
TI - Process evaluation of a cluster randomised intervention in Swedish primary care: using care managers in collaborative care to improve care quality for patients with depression
U1 - General Literature
U2 - 31351444
U3 - 10.1186/s12875-019-0998-4
VL - 20
VO - 1471-2296; 1471-2296
Y1 - 2019
Y2 - Jul 27
ER -