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RRP 07-291 – QUERI Project

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RRP 07-291
Care for Depression at Hub and Spoke Facilities in the SCI/D System
Philip M. Ullrich PhD
VA Puget Sound Health Care System Seattle Division, Seattle, WA
Seattle, WA
Funding Period: September 2008 - December 2009

BACKGROUND/RATIONALE:
The Consortium for Spinal Cord Medicine (CSCM) clinical practice guideline (CPG) for depression after SCI states that interdisciplinary care is required to address the complicated interplay of biological, psychological, and social factors important to depression among persons with SCI. It may be especially difficult to deliver CPG-consistent care for depression among SCI populations at spoke facilities in the VA SCI system of care, where interdisciplinary SCI specialty care may not be available.

OBJECTIVE(S):
This project aimed to 1) characterize current practices and determinants of current practices in caring for depression at SCI/D spoke facilities, 2) pilot a program coordinated between hub and spoke facilities to implement the CSCM CPG for depression after SCI, in part through a telephone outreach program.

METHODS:
Questionnaires, semi-structured interviews, a face-to-face meeting and monthly phone conferences were planned to be utilized to address study objectives. The sample included 39 spoke facility personnel and 7 SCI center personnel. Questionnaire data were analyzed descriptively.

FINDINGS/RESULTS:
Questionnaire responses were received from only 9 of the 39 spoke facility personnel after multiple and varied efforts to recruit participants. Many questionnaire items were left blank and no participants indicated interest in participating in telephone interviews or other follow-up.

IMPACT:
Impact is limited because the project did not advance beyond the initial stages.

PUBLICATIONS:

Conference Presentations

  1. Rapacki L, Evans (Mayfield) C, Chin A, Weaver FM, Ullrich PM, Burns SP, Goldstein B. Psychiatric impairments in OEF/OIF SCI Active Duty Service Members (ADSM) in Different Military Disciplines. Poster session presented at: Spinal Cord Medicine and Rehabilitation Annual Congress; 2009 Sep 23; Dallas, TX.


DRA: Mental, Cognitive and Behavioral Disorders
DRE: none
Keywords: Depression, Spinal cord injury
MeSH Terms: none

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