The impact of electronic health record functions on patterns of depression treatment in primary care.

IF 2.5 4区医学 Q2 HEALTH CARE SCIENCES & SERVICES

Informatics for Health & Social Care Pub Date : 2022-07-03 Epub Date: 2021-10-21 DOI:10.1080/17538157.2021.1990933

Elizabeth B Matthews, Ayse Akincigil

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引用次数: 1

Abstract

Background: Many individuals with depression are not being linked to treatment by their primary care providers. Electronic health records (EHRs) are common in medicine, but their impact on depression treatment is mixed. Because EHRs are diverse, differences may be attributable to differences in functionality. This study examines the relationship between EHR functions, and patterns of depression treatment in primary care.

Methods: secondary analyses from the 2013-2016 National Ambulatory Medical Care Survey examined adult primary care patients with new or acute depression (n = 5,368). Bivariate comparisons examined patterns of depression treatment by general EHR use, and logistic regression examined the impact of individual EHR functions on treatment receipt.

Results: Half the sample (57%; N = 3,034) was linked to depression treatment. Of this, 98.5% (n = 2,985) were prescribed antidepressants, while 4.3% (n = 130) were linked to mental health. EHR use did not impact mental health linkages, but EHR functions did affect antidepressant prescribing. Medication reconciliation decreased the odds of receiving an antidepressant (OR = .60, p < .05), while contraindication warnings increased the likelihood of an antidepressant prescription (OR = 1.91, p < .001).

Conclusions: EHR systems did not impact mental health linkages but improved rates of antidepressant prescribing. Optimizing the use of contraindication warnings may be a key mechanism to encourage antidepressant treatment.

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电子健康记录功能对初级保健中抑郁症治疗模式的影响

背景:许多抑郁症患者没有接受初级保健提供者的治疗。电子健康记录(EHRs)在医学上很常见，但它们对抑郁症治疗的影响好坏参半。由于电子病历的多样性，其差异可能归因于功能的差异。本研究探讨了电子病历功能与初级保健中抑郁症治疗模式之间的关系。方法:对2013-2016年全国门诊医疗调查中患有新发或急性抑郁症的成人初级保健患者(n = 5368)进行二次分析。双变量比较检验了一般电子病历治疗抑郁症的模式，逻辑回归检验了个人电子病历功能对治疗接收的影响。结果:半数样本(57%;N = 3034)与抑郁症治疗有关。其中，98.5% (n = 2985)服用了抗抑郁药，4.3% (n = 130)与精神健康有关。电子病历的使用不影响心理健康联系，但电子病历功能确实影响抗抑郁药的处方。药物调解降低了接受抗抑郁药的几率(OR = 0.60, p)。结论:电子病历系统对心理健康没有影响，但提高了抗抑郁药的处方率。优化禁忌症警告的使用可能是鼓励抗抑郁治疗的关键机制。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Informatics for Health & Social Care 医学-卫生保健

CiteScore

6.10

自引率

4.20%

发文量

审稿时长

>12 weeks

期刊介绍： Informatics for Health & Social Care promotes evidence-based informatics as applied to the domain of health and social care. It showcases informatics research and practice within the many and diverse contexts of care; it takes personal information, both its direct and indirect use, as its central focus. The scope of the Journal is broad, encompassing both the properties of care information and the life-cycle of associated information systems. Consideration of the properties of care information will necessarily include the data itself, its representation, structure, and associated processes, as well as the context of its use, highlighting the related communication, computational, cognitive, social and ethical aspects. Consideration of the life-cycle of care information systems includes full range from requirements, specifications, theoretical models and conceptual design through to sustainable implementations, and the valuation of impacts. Empirical evidence experiences related to implementation are particularly welcome. Informatics in Health & Social Care seeks to consolidate and add to the core knowledge within the disciplines of Health and Social Care Informatics. The Journal therefore welcomes scientific papers, case studies and literature reviews. Examples of novel approaches are particularly welcome. Articles might, for example, show how care data is collected and transformed into useful and usable information, how informatics research is translated into practice, how specific results can be generalised, or perhaps provide case studies that facilitate learning from experience.