What is the Mood Outcomes Program?
The aim of the NNDC Mood Outcomes Program is to improve patient care provided to those suffering with mood disorders. Through use of measurement-based care tools and quality improvement programs informed by patient care data at our centers, the NNDC is working to transform the treatment of mood disorders.
The electronic patient reported outcomes (ePRO) web-based system allows patients to directly input four brief self-rated assessments immediately before each clinic visit. Clinicians review these self-assessments during regular visits to monitor patient progress as part of standard clinical care.
The Mood Outcomes Program Clinical Repository includes a patient-level dashboard that displays the self-rating assessments in real time so that clinicians can use this data during their visit with the patient. The Clinical Repository also features reporting tools to help clinicians establish treatment plans that are tailored to the specific needs of their patients.
- PHQ-9 Patient Health Questionnaire
- GAD-7 Generalized Anxiety Disorder Assessment
- ASRM Altman Self-Rating Mania Scale
- C-SSRS Columbia Suicide Severity Rating Scale
NNDC Member Centers are leading the effort to build the Mood Outcomes program into a robust clinical program and patient database to transform patient care and improve quality. All patients 13 years or older who have been diagnosed with a mood disorder, including depression and bipolar disorder, and are being cared for at one of the participating NNDC Member clinics may be included in the program.
Vital Signs for Mood Disorders
Common assessment tools are critical for both arriving at reliable diagnoses and tracking outcomes. Currently, a number of different evidence-based tools are used to diagnose depression, bipolar illness and related conditions in research and clinical settings. Prior to the formation of the NNDC, there has been no commonly-accepted clinical language to describe and screen for depression, bipolar disorder and related illnesses.
The importance of developing a standard set of screening and monitoring tools – a common way for clinicians everywhere to take the mental “vital signs” of a patient – cannot be overemphasized. According to the National Institute of Mental Health (NIMH) in 2009, depression or bipolar disorder is misdiagnosed or completely missed as often as half the time by current standards of assessment. There are also no early screening tests for adolescents, though depression is increasing among children.
In response, the NNDC has developed a package of standardized screening and monitoring measures for these illnesses. The package contains five different patient-rated evaluative measures. The dissemination of these scales across centers is a vital first step toward improving diagnosis and treatment and designing stronger research studies.
The NNDC is leading a national effort to create a comprehensive research registry to facilitate the kind of large-scale, longitudinal, multi-site studies needed to identify predictors of risk and resilience that can eventually lead to the development of early intervention or even prevention strategies for depression and bipolar disorders.
Building the registry is an ambitious task involving the compilation, standardization, analysis and archiving of data from mental healthcare, primary care and community settings as well as information from a variety of NNDC projects including biomarker measures, clinical, observational and trial data, economic data and more.
A vital milestone in this project was the formation NNDC Data Coordinating Center (DaCC), a de-identified database management system currently being operated in conjunction with the Michigan Institute for Clinical and Health Research (MICHR) at the University of Michigan, which is paving the way for future research endeavors by compiling and standardizing data collection and ensuring platform compatibility across NNDC sites.