In support of this mission, AHRQ
funded a prior project to harmonize the outcome measures collected
across patient registries and routine clinical practice, with the
goals of supporting the development of a robust data infrastructure
that can consistently and efficiently collect high-quality data on
outcome measures that are relevant to patients and clinicians and
supporting patient-centered outcomes research and quality
improvement. Harmonized outcome measures would also form the
foundation for learning healthcare systems. Of note, AHRQ has
supported the development of the Outcome Measures Framework (OMF).
The OMF is a conceptual model for classifying outcomes that are
relevant to patients and providers across most conditions. AHRQ, in
collaboration with the U.S. Food and Drug Administration and the
National Library of Medicine, recently supported an effort to use
the OMF as a content model for developing harmonized outcome
measures in specific disease areas, including depression. Major
depressive disorder (MDD) is a common mental disorder that affects
an estimated 16.2 million adults and 3.1 million adolescents in the
United States. Characterized by changes in mood, cognitive
function, and/or physical function that persist for two or more
weeks, MDD can reduce quality of life substantially, impair
function at home, work, school, and in social settings, and result
in increased mortality due to suicide. MDD also is a major cause of
disability, with an economic burden of approximately $210.5 billion
per year in the United States. Despite the burden of MDD and the
availability of treatment, the condition is often undiagnosed and
untreated. In 2016, the U.S. Preventive Services Task Force
recommended screening for depression in the general adult
population, including pregnant and postpartum women, and in
adolescents. While routine screening is intended to improve
diagnosis and treatment of MDD, many questions remain, such as
about the comparative effectiveness of different treatment
approaches, the incidence of adverse events, when to add
medications for patients who do not respond to an initial course of
treatment, how and why depression recurs, and how to classify and
treat treatment-resistant depression. Patient registries capture a
wealth of data on depression treatment patterns and outcomes in the
United States and could serve as the foundation for a national
research infrastructure to address these and other research
questions. Yet, a lack of harmonization in the outcome measures
collected by each registry makes it challenging, if not impossible,
to link and compare data across registries and related efforts. As
documented in the prior project, existing registries use different
outcome measures (e.g., remission as defined by the PHQ-9 vs.
HAM-D) and capture data at different timepoints. Depression
registries offer an excellent opportunity to demonstrate the
feasibility and value of implementing the harmonized outcome
measures. Existing registries already capture some of the
harmonized depression measures for quality reporting, although at
different timepoints; capture of these measures and the additional
measures at consistent intervals will enable the registries to
generate more robust data suitable for research purposes. AHRQ is
now proposing to implement the harmonized depression outcome
measures developed under the prior project in two patient
registries (the PRIME Registry and PsychPRO) and a health system
setting. The purpose of this project is to demonstrate that
capturing the harmonized outcome measures in the clinical workflow
and submitting these data to different registries can improve
clinical care, reduce the burden of registry participation, and
increase the utility of registry data for research purposes. The
objectives of the project are to: - Demonstrate that collection of
the harmonized outcome measures is feasible, sustainable, and
useful for clinicians participating in primary care and
ment
US Code:
42
USC 299 Name of Law: Healthcare Research and Quality Act of
1999
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