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The implementation and evaluation of an evidence-based eHealth depression prevention intervention in primary care; conducting a process evaluation and a (cost-)effectiveness study

Projectomschrijving

Kleurjeleven is een online cursus om mensen met depressieve klachten te helpen. In dit project wilden we huisartsen en praktijkondersteuners GGZ (POH’s-GGZ) van 7 huisartsenorganisaties met in totaal 500.000 patiënten kennis laten maken met Kleurjeleven, zodat zij het aan hun patiënten konden aanbieden. Hiervoor zijn de POH’s-GGZ getraind. De meesten (90%) van de 631 patiënten aan wie Kleurjeleven was aangeboden, zijn gestart met Kleurjeleven. De patiënten konden thuis zelfstandig met het programma aan de slag. In gesprekken met de POH-GGZ konden patiënten vertellen hoe het ging en vragen stellen. Zowel patiënten als POH’s-GGZ waren tevreden. POH’s-GGZ vonden het soms moeilijk en soms makkelijk om patiënten te begeleiden. Bij veel patiënten zijn hun klachten door het volgen van Kleurjeleven en de begeleiding door de POH-GGZ verminderd.

Producten

Titel: Implementatie blended Kleurjeleven in de huisartsenzorg.
Auteur: Smeets, O.
Titel: E-mental health in de huisartsenpraktijk.
Auteur: Smeets, O.
Titel: Blended care-kaders voor zorgvuldige uitvoering.
Auteur: Smeets, O.
Titel: E-mental health in de huisartsenpraktijk.
Auteur: Smeets, O.
Titel: Digitale zorg samen. Online GGZ: Ins en outs van online hulp bij psychische problemen.
Auteur: Martin Abello, K., Smeets, O.
Titel: E-mental health bij de huisarts
Auteur: Wind, L. & Smeets, O.
Titel: Implementatie blended Kleurjeleven in de huisartsenzorg
Auteur: Smeets, O.
Titel: Module Preventie en e-(mental) health.
Auteur: Smeets, O.
Titel: Implementatie E-mental health bij de huisarts
Auteur: Smeets, O.
Titel: E-mental health: Sociale zorg!
Auteur: Smeets, O.
Titel: Implementatie blended Kleurjeleven in de huisartsenzorg
Auteur: Smeets, O., & Zijlstra-Vlasveld, M.C.
Titel: Tussentijdse resultaten implementatie blended Kleurjeleven in de huisartsenpraktijk.
Auteur: Smeets, O.
Titel: Implementatie blended Kleurjeleven in de huisartsenzorg
Auteur: Zijlstra-Vlasveld, M.C.
Titel: E-mental health in de basis GGZ.
Auteur: Smeets, O.
Titel: Implementatie blended Kleurjeleven in de huisartsenzorg.
Auteur: Smeets, O.
Titel: Colour Your Life
Auteur: Smeets, O.
Titel: Implementatie ‘Blended e-(mental) health in de huisartsenpraktijk’. Resultaten en lessons learned van de implementatie van blended Kleurjeleven in de huisartsenzorg.
Auteur: Smeets, O., Zijlstra-Vlasveld, M.
Titel: Implementation ‘ Blended e-(mental) health in general practice’ Results and lessons learned from the implementation of blended ‘Kleurjeleven’ (Colouryourlife) in primary care.
Auteur: Smeets, O., Zijlstra-Vlasveld, M.
Titel: E-health in de GGZ: hoe staat het daar nu mee?
Auteur: Smeets, O., Abello, K.M., Zijlstra-Vlasveld, M., Boon, B.
Magazine: Nederlands Tijdschrift voor Geneeskunde
Titel: Odile Smeets: Persuasive Technology heeft de toekomst” Hoe kun je mensen verleiden om online hulp- en zelfhulpprogramma’s te gaan volgen en dat ook vol te houden?
Auteur: Blijleven R., Jekel. G, Weel, A.
Magazine: Tijdschrift voor Bedrijfs- en verzekeringsgeneeskunde
Titel: Al 300 levens gekleurd
Auteur: Stolk, G.
Magazine: De eerstelijns
Titel: Implementatie van blended Kleurjeleven in de huisartspraktijk.
Auteur: Zijlstra-Vlasveld, M.C., van der Poel, A., Smeets, O.
Magazine: Tijdschrift voor Praktijkondersteuning
Titel: E-mental health
Auteur: Duivenboden, J. van, Smeets, O., & Poel, A. van der
Titel: Implementation ‘Blended e-(mental) health in general practice’
Auteur: Odile Smeets Moniek Zijlstra-Vlasveld
Link: http://www.trimbos.org
Titel: Eindrapport Implementatie 'Blended e-(mental) health in de huisartsenpraktijk'.
Auteur: Odile Smeets Moniek Zijlstra-Vlasveld
Link: https://www.trimbos.nl/producten-en-diensten/webwinkel/product/?prod=af1519

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Samenvatting van de aanvraag

BACKGROUND The sustainability of the Dutch health care system is under considerable pressure due to a combination of factors such as increasing health care expenditure driven by an increased demand for health care in a context of a greying society, a dwindling labor force for health care, and the current economic down-turn with all entailing austerity measures. These factors combine to more urgently look for innovative approaches to health care delivery such that a more efficient use of available resources can be made and the health care system would still be able to generate the best possible health gains for the population. In short, the Dutch government looks for ways to reduce health care expenditure without compromising the quality of the Dutch health care system. Options currently under review are offering health care there where it can be provided for relatively low costs (e.g. in the primary care sector rather than in the out-patient and in-patient setting). The Dutch government also expressed preferences for early detection and early intervention, minimally supported self-management and e-health interventions – in particular in diseases such as depressive disorder known to be associated with a substantial disease burden and staggering economic costs to society. Our project has to be placed in this context. We propose to implement an existing and evidence-based e-health intervention for depressive disorder in the primary health care setting and to evaluate how this e-health intervention helps to improve population health in a more cost-efficient way than routine primary care alone. INTERVENTION In this project we chose to implement ColourYourLife, which is an online self-help (self-management) intervention for the early manifestations of depressive disorder. ColourYourLife has been officially certified by the Centre for Healthy Living (“Centrum Gezond Leven”) as an effective and evidence-based intervention. ColourYourLife is also recommended as a first line intervention by the Multidisciplinary Clinical Guideline for Depressive Disorder. And importantly, ColourYourLife is reimbursed by nearly all Dutch health care insurers. ColourYourLife has attained this almost privileged position, because there is a large body of evidence that e-health interventions are effective in depression (Van Straten et al., 2007; Spek et al., 2007; Clarke et al., 2005; Andersson et al., 2006; Christensen et al., 2004; Patten, 2003; Clarke et al., 2002; Cuijpers, 2009; Munoz et al., 2011) and in (co-morbid) anxiety disorders (Klein & Richards, 2001; Klein et al., 2006; Marks et al., 2007; Richards et al., 2006; Andersson et al., 2006; Lange et al., 2005; Lange et al., 2001; Hirai & Clum, 2005; Marks et al., 2007; Marks & Cavanagh, 2009; Barak et al., 2008). In addition, there is evidence that e-health interventions such as ColourYourLife are cost-effective (Huibers et al., 2009; Warmerdam et al., 2010). It may therefore come as a surprise that ColourYourLife is hardly implemented in the primary care setting – a setting which has to face a quarter of a million patients presenting with depressive symptoms and an additional half million patients presenting with full-blown manifestations of the disorder every year. In a previous study (Boerema et al., 2009) we identified a number of barriers to full implementation, but among those listed were no fundamental stumbling blocks to the adoption of ColourYourLife in primary care centers. The proposed project aims to remove these barriers and to accelerate the implementation of ColourYourLife in the primary care setting. AIMS 1. To design and execute a plan for implementing the ColourYourLife intervention in primary care centers, 2. To monitor the trial-implementation to guarantee its good progress and to further fine-tune the implementation plan for future use, 3. To evaluate the patient-level health gains and cost-effectiveness and thus to provide a business case for the project’s post-implementation continuation and consolidation. DELIVERABLES The main deliverables of the project are following - Installation of implementation platform - Draft implementation working plan - Definition of roles and responsibilities in Project Start Up document - Adapted version of Colour Your Life according to the implementation needs - Manual and protocol for usage of the intervention and follow-up system - Training manual - Locally adapted implementation working plans - Agreement on goals and organization of post project implementation continuation - Final implementation working plan - Manuscript in which results of the cost-effectiveness study are presented, submitted to an international peer-reviewed scientific Journal.

Onderwerpen

Kenmerken

Projectnummer:
200210019
Looptijd: 100%
Looptijd: 100 %
2012
2016
Onderdeel van programma:
Gerelateerde subsidieronde:
Projectleider en penvoerder:
Dr. B.J.F. Boon
Verantwoordelijke organisatie:
Trimbos-instituut