Implementation of a Clinical Decision Support Tool for Postpartum Depression
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Clinical Decision Support Tool.
- Who it may be relevant to
- Registry conditions: Postpartum Depression. Basic parameters: from 18 years · Female.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- United States
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Overview
This study will evaluate the use of an automated process in the electronic health record (EHR) that will help providers to detect patients at risk of developing postpartum depression (PPD).
Detailed description
The goal of this randomized clinical trial is to assess the implementation of a clinical decision support (CDS) tool. The tool is designed to assist providers in managing patients at risk of developing of postpartum depression.
Investigators hypothesize that this tool will be acceptable and feasible for use and improve the use of mental health services for postpartum depression.
Patients in the control arm will receive usual care, while those in the intervention arm will receive CDS.
Clinicians will manage patients per usual care, including initiating PPD preventive such as conducting referrals to nutrition and behavioral health, suggest educational readings through patient portals, or no actions. Clinicians in the intervention arm will refer patients based on the CDS.
Interventions
- Other Clinical Decision Support Tool
The CDS in and AI algorithm that will alert clinicians only if patients have high risk of developing PPD, and provide clinicians with risk score, risk factors, and anticipatory actions with an order set to assist with ordering. Clinicians will make the ultimate clinical judgement after receiving CDS aid, including taking no actions towards PPD prevention. Clinicians will manage patients per usual care, including initiating PPD prevention such as conducting referrals to nutrition and behavioral h
Primary outcome measures
- Acceptability as measured by Unified Theory of Technology Acceptance Theory (UTAUT). [Time frame: One month after initiation of tool use and three months after use.]
- Appropriateness as measured by Appropriateness Measure (IAM). [Time frame: One month after initiation of tool use and three months after use.]
- Feasibility as measured by Feasibility of Intervention Measure (FIM). [Time frame: One month after initiation of tool use and three months after use.]
- Mental Health service utilization as measured by number of mental health visits [Time frame: one month and three month]
Eligibility criteria
Inclusion criteria
- 18 years or older
- being seen at one of participating clinics
- pregnancy at 20 week gestation or more
Exclusion criteria
- Does not speak inclusion
- does not have internet access
Clinician eligibility:
- If they manage patients in the three clinics as a board-certified OBGYN clinician.
- No exclusion criteria apply for clinician based on their knowledge and experience in treating PPD
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: Yes
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Open label
- Primary purpose
- Supportive care
Study locations
United States · 4 centers
- Center for Community Health: 515 6th street (3rd floor) — Brooklyn
- Ob GYN Lower Manhattan 156 William street, New York City — New York
- Weill Cornell Medicine OBGYN practice 72 street — New York
- Weill Cornell Medicine- Women's Health practice 505 East 70th street, New York City — New York
Publications
- Krause N, Borawski-Clark E. Social class differences in social support among older adults. Gerontologist. 1995 Aug;35(4):498-508. doi: 10.1093/geront/35.4.498. PMID 7557520
- Rabin R, de Charro F. EQ-5D: a measure of health status from the EuroQol Group. Ann Med. 2001 Jul;33(5):337-43. doi: 10.3109/07853890109002087. PMID 11491192
- Weiner BJ, Lewis CC, Stanick C, Powell BJ, Dorsey CN, Clary AS, Boynton MH, Halko H. Psychometric assessment of three newly developed implementation outcome measures. Implement Sci. 2017 Aug 29;12(1):108. doi: 10.1186/s13012-017-0635-3. PMID 28851459
- Zhang Y, Wang S, Hermann A, Joly R, Pathak J. Development and validation of a machine learning algorithm for predicting the risk of postpartum depression among pregnant women. J Affect Disord. 2021 Jan 15;279:1-8. doi: 10.1016/j.jad.2020.09.113. Epub 2020 Sep 30. PMID 33035748
- Wang S, Pathak J, Zhang Y. Using Electronic Health Records and Machine Learning to Predict Postpartum Depression. Stud Health Technol Inform. 2019 Aug 21;264:888-892. doi: 10.3233/SHTI190351. PMID 31438052
- Venkatesh KK, Nadel H, Blewett D, Freeman MP, Kaimal AJ, Riley LE. Implementation of universal screening for depression during pregnancy: feasibility and impact on obstetric care. Am J Obstet Gynecol. 2016 Oct;215(4):517.e1-8. doi: 10.1016/j.ajog.2016.05.024. Epub 2016 May 20. PMID 27210067
- Dunkel Schetter C, Tanner L. Anxiety, depression and stress in pregnancy: implications for mothers, children, research, and practice. Curr Opin Psychiatry. 2012 Mar;25(2):141-8. doi: 10.1097/YCO.0b013e3283503680. PMID 22262028
- Cox EQ, Sowa NA, Meltzer-Brody SE, Gaynes BN. The Perinatal Depression Treatment Cascade: Baby Steps Toward Improving Outcomes. J Clin Psychiatry. 2016 Sep;77(9):1189-1200. doi: 10.4088/JCP.15r10174. PMID 27780317
Identifiers
NCT: NCT06818734 · 24-03027259