New smartphone app provides point-of-care treatment algorithms for major depression

Columbia Psychiatry faculty in partnership with avoMD a next-gen clinical decision support platform, have developed an interactive smartphone application that provides point-of-care treatment algorithms for major depression.

The app-;known as Columbia Psychiatry Pathways-;supports and strengthens the ability of clinicians to provide critical mental health services in an outpatient setting.

Depression is fast becoming the leading cause of disability worldwide, and the frontline of treating professionals for major depression are PCPs and internists. This app is designed to help clinicians treat depression more effectively. It also helps them monitor the patient response and when a referral may be indicated."

J. John Mann, MD, the Paul Janssen Professor of Translational Neuroscience (in Psychiatry and in Radiology)

One of the challenges of screening for depression, particularly in primary care, is that providers don't always know what to do next.

"Scientific papers and clinical guidelines are constantly evolving. It's difficult for health care providers to stay up to date," said Ravi N. Shah, MD, co-inventor and Chief Innovation Officer, Columbia Psychiatry. "This app combines the world-class expertise of Columbia Psychiatry with avoMD's next-generation decision support technology to put the latest scientific knowledge in the hands of clinicians, serving as an interactive playbook to treat depression quickly and effectively."

Combining software with clinical expertise

The clinical decision support tool, developed by Drs. Shah and Mann in collaboration with avoMD, is intended for use by psychiatrists, primary care physicians, nurse practitioners, physician assistants, medical students, residents, and trainees in outpatient settings as they treat patients with major depression.

Available as a mobile app and on desktop devices, the evidence-based platform updates prior depression treatment guidelines. The algorithm focuses on faster medication adjustments with emphasis on the seven best-tolerated generic antidepressants.

It measures symptom severity using built-in calculators based on the Columbia Depression Scale and includes screenings for bipolar disorder and suicide risk.

Primary care treatment of depression can save lives

The World Health Organization estimates that 5 percent of the world's population (around 280 million people) suffer from depression. Depression is strongly associated with suicide ideation and attempts, with suicide claiming more than 700,00 lives each year.

Research has shown that primary care providers who integrate behavioral health into their practices can improve clinical outcomes and even save lives. In a systematic review of suicide prevention strategies, Columbia researchers found that training primary care physicians in depression recognition and medication treatment prevents suicide, often halving the risk.

Though primary care providers are frequently on the front lines of managing patients' depression, they may feel inadequately trained or under-resourced to effectively treat and monitor to prevent relapse.

David Buchholz, MD, Senior Founding Medical Director, Primary Care, at Columbia University Irving Medical Center, believes primary care practitioners will welcome the Columbia Psychiatry Pathways app into their practice.

"Treating major depression in a primary care setting, especially in a patient with comorbid conditions, is challenging," Buchholz said. "An app that serves as virtual consult at the point of care can validate a PCP's knowledge and give us confidence that we can do a good job caring for patients."

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