POKAL - PrädiktOren und Klinische Ergebnisse bei depressiven ErkrAnkungen in der hausärztLichen Versorgung / Predictors and Outcomes in Primary Depression Care
As life expectancy is rising, society is getting older. However, the number of patients suffering from several chronic diseases in old age is also increasing. As such, mental illnesses, especially depression, are becoming increasingly common in this demographic group. Moreover, such mental illnesses also tend to be more complex and intertwined given other chronic diseases, which renders diagnosis and treatment more difficult. This poses great challenges for family doctors in particular. They are the first point of contact for most patients, including those suffering from multiple illnesses (comorbidities) and depressions. However, as it is difficult to differentiate between the various symptoms of depression, it is often not easy to make a precise diagnosis by clinicians.
The research project POKAL aims to develop new diagnostic and treatment approaches and implementation aids for primary care. The goal is to significantly improve the care of patients with depression in family doctors’ offices and to qualify the next generation of scientists in the field. The specific needs of patients with depression in primary care are to be addressed through new depression-specific diagnostic and therapeutic instruments. The individual projects of the project partners are structured around the "Chronic Care Model" (CCM) as a common research guiding working model. It understands the synergistic interaction of instruments for self-management, clinical cooperation, evidence-based decision support and clinical data use as a prerequisite for improved results in patients with chronic diseases.
Realization and Aim of Subproject 8 “Patient Data”
Our research group devotes its work to subproject 8 “Patient Data”, which investigates the relevant patient data as well as requirements, opportunities, and barriers for data-based assurance of treatment success and avoidance of treatment risks. This subproject is dedicated to the assumption that patients should be integrated more strongly into diagnosis and therapy. Our approach is to evaluate suitable IT-supported strategies that enable a better treatment success (e.g. faster start of therapy, more targeted therapy, monitoring of a change in therapy) through active participation in data collection and interpretation by the patient. Therefore, in terms of the CCM, a user-oriented prototype for IT-supported data collection from patients with multimorbidity and depression should be developed. The prototype concept including the aggregation of depression-relevant data serves as the technical basis for the IT-supported strategies. The intensive involvement of doctors and patients in the development process (design science method, interviews) is intended to ensure a high level of acceptance by both target groups and to avoid uncertainty among patients due to early indicators. The project will be completed in three phases. The following description of aim and work packages cover phase 1 (3 years):
Aim (Phase 1):
- Identification of barriers and potentials of the usage of patient-generated data for the support of depression treatment
- Evaluation of a digital data prototype with patient-generated data for the purpose of depression care
Work Packages (Phase 1):
- A structured literature review to identify IT-supported mechanisms with relevance for clinician-patient interaction in patients with depression
- A design thinking workshop with physicians and patients to derive the relevant patient data needed to ensure the effectiveness and safety of depression treatment
- A standardized survey to verify the relevance of the patient data as well as the user acceptance of patients
- Iterative development of a prototype for IT-supported data collection in cooperation with physicians and patients, including the design of a semantic data model and testing of different data analysis and visualization approaches
Figure 1 provides an overview of the methodology for the project
In the CCM, diagnosis and therapy-relevant data collected from the patient using IT tools (apps, sensors) and the resulting improved "doctor-patient interaction" aims to improve treatment results in primary depression care.
The research group “PrädiktOren und Klinische Ergebnisse bei depressiven ErkrAnkungen in der hausärztLichen Versorgung (POKAL, DFG-GRK 2621)” is funded by the Deutsche Forschungsgemeinschaft (DFG).