{"id":1745,"date":"2019-10-02T08:39:26","date_gmt":"2019-10-01T23:39:26","guid":{"rendered":"http:\/\/www.hcfm.jp\/journal\/?p=1745"},"modified":"2019-10-02T11:14:18","modified_gmt":"2019-10-02T02:14:18","slug":"%e3%83%97%e3%83%a9%e3%82%a4%e3%83%9e%e3%83%aa%e3%82%b1%e3%82%a2%e3%81%ab%e3%81%8a%e3%81%91%e3%82%8b%e3%81%86%e3%81%a4%e7%97%85%e3%81%ae%e7%96%ab%e5%ad%a6","status":"publish","type":"post","link":"https:\/\/www.hcfm.jp\/journal\/?p=1745","title":{"rendered":"\u30d7\u30e9\u30a4\u30de\u30ea\u30b1\u30a2\u306b\u304a\u3051\u308b\u3046\u3064\u75c5\u306e\u75ab\u5b66"},"content":{"rendered":"<p>\uff0d\u6587\u732e\u540d\uff0d<br \/>\nManish K. Jha, MD, et al. A structured approach to detecting and treating depression in primary care:<br \/>\nVitalSign6 project. Annals of Family Medicine. 2019;4(17):326-334.<\/p>\n<p>\uff0d\u8981\u7d04\uff0d<br \/>\n\uf06e Purpose:<br \/>\n\u3053\u306e\u5831\u544a\u3067\u306f\u3001\u7c73\u56fd\u306e\u5927\u90fd\u5e02\u570f\u3067\u9032\u884c\u4e2d\u306e\u300116\u306e\u30d7\u30e9\u30a4\u30de\u30ea\u30b1\u30a2\u30af\u30ea\u30cb\u30c3\u30af\u306b\u304a\u3051\u308b\u3046\u3064\u75c5\u60a3\u8005\u306e\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u3001<br \/>\n\u6cbb\u7642\u304a\u3088\u3073\u30a2\u30a6\u30c8\u30ab\u30e0\u3092\u6539\u5584\u3059\u308b\u305f\u3081\u306b\u884c\u308f\u308c\u305f\u300c\u8cea\u306e\u6539\u5584\u30d7\u30ed\u30b8\u30a7\u30af\u30c8(VitalSign6)\u300d\u306e\u7d50\u679c\u306b\u3064\u3044\u3066\u8a18\u8ff0\u3057\u3066\u3044\u308b\u3002<\/p>\n<p>\u30fb16\u306e\u30af\u30ea\u30cb\u30c3\u30af\u306e\u5185\u8a33\uff1a6\u3064\u306echarity clinic\u30016\u3064\u306e\u9023\u90a6\u653f\u5e9c\u8a8d\u5b9ahealth care center\u30012\u3064\u306e\u6c11\u9593\u306e\u4f4e\u6240\u5f97\u8005\u5c64\u5411\u3051\u30af\u30ea\u30cb\u30c3\u30af\u3001<br \/>\n\u30002\u3064\u306e\u6c11\u9593\u306e\u30e1\u30c7\u30a3\u30b1\u30a2\u3042\u308b\u3044\u306f\u79c1\u7684\u4fdd\u967a\u306b\u52a0\u5165\u3057\u3066\u3044\u308b\u60a3\u8005\u306e\u305f\u3081\u306e\u30af\u30ea\u30cb\u30c3\u30af<\/p>\n<p>\uf06e Method\uff1a<br \/>\n\u3053\u306e\u5f8c\u308d\u5411\u304d\u5206\u6790\u306e\u5bfe\u8c61\u306f\u3001\u524d\u8ff0\u306e\u300c\u8cea\u306e\u6539\u5584\u30d7\u30ed\u30b8\u30a7\u30af\u30c8\u300d\u306b\u304a\u3044\u3066PHQ-2\u3067\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u3055\u308c\u305f25000\u4eba\u306e\u60a3\u8005\uff0812\u6b73\u4ee5\u4e0a\uff09\u3067\u3042\u308b\u3002<br \/>\n\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u967d\u6027\uff08PHQ-2&gt;2\uff09\u3068\u306a\u3063\u305f\u60a3\u8005\u306f\u3001\u81ea\u8a18\u5f0f\u8cea\u554f\u7968\u3068clinician\u306e\u8a3a\u5bdf\u306b\u3088\u3063\u3066\u3055\u3089\u306a\u308b\u8a55\u4fa1\u304c\u884c\u308f\u308c\u305f\u3002<br \/>\n2014\u5e74\uff18\u6708\u304b\u30892016\u5e7411\u6708\u307e\u3067\u306b\u96c6\u3081\u3089\u308c\u305f\u30c7\u30fc\u30bf\u306f\uff13\u7a2e\u985e\u3067\u3001(1)\u5f53\u521d\u306ePHQ-2\u65bd\u884c\u7fa4(n=25000)\u3001(2\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u967d\u6027\u7fa4(n=4325)\u3001(3)clinician\u306b\u3088\u3063\u3066\u3046\u3064\u75c5\u3068\u8a3a\u65ad\u3055\u308c\u3001<br \/>\n18\u9031\u9593\u4ee5\u4e0a\u767b\u9332\u3055\u308c\u3066\u3044\u305f\u7fa4(n=2160)\u3067\u3042\u308b\u3002<\/p>\n<p>\uf06e Results\uff1a<br \/>\n\u3046\u3064\u75c5\u306e\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u3055\u308c\u305f\u60a3\u8005\u306e17.3%(4325\/25000)\u304c\u967d\u6027\u3068\u5224\u5b9a\u3055\u308c\u305f\u3002<br \/>\n\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u967d\u6027\u3060\u3063\u305f\u60a3\u8005\u306e\u3046\u3061\u3001clinician\u306e\u8a3a\u5bdf\u306b\u3088\u3063\u3066\u3046\u3064\u75c5\u3068\u8a3a\u65ad\u3055\u308c\u305f\u306e\u306f56.1%(2426\/4325)\u3067\u3042\u3063\u305f\u3002<br \/>\n18\u9031\u9593\u4ee5\u4e0a\u767b\u9332\u3055\u308c\u305f\u60a3\u8005\u306e\u3046\u3061\u300164.8%\u304cmeasurement-based pharmacotherapy\u3092\u958b\u59cb\u3055\u308c\u30018.9%\u304c\u5916\u90e8\u306e\u5c02\u9580\u5bb6\u306b\u7d39\u4ecb\u3055\u308c\u305f\u3002<br \/>\n\u85ac\u7269\u7642\u6cd5\u3092\u958b\u59cb\u3057\u305f1400\u4eba\u306e\u60a3\u8005\u306e\u3046\u3061\u3001\u30d5\u30a9\u30ed\u30fc\u30a2\u30c3\u30d7\u306e\u56de\u6570\u306f\u30010\u56de45.5%\u30011\u56de30.2%\u30012\u56de12.6%\u30013\u56de\u4ee5\u4e0a11.6%\u3067\u3042\u3063\u305f\u3002<br \/>\n\u5bdb\u89e3\u7387\u306f\u3001\u30d5\u30a9\u30ed\u30fc\u30a2\u30c3\u30d7\u56de\u6570\u304c1\u56de20.3%(86\/423)\u30012\u56de31.6%(56\/177)\u30013\u56de\u4ee5\u4e0a41.7%(68\/163)\u3067\u3042\u3063\u305f\u3002<br \/>\n\u30d9\u30fc\u30b9\u30e9\u30a4\u30f3\u306e\u7279\u5fb4\u3068\u3057\u3066\u3001\u8131\u843d\u7387\u306e\u9ad8\u3055\u3068\u95a2\u9023\u3057\u3066\u3044\u305f\u306e\u306f\u3001\u975e\u767d\u4eba\u3001\u85ac\u7269\u4e71\u7528\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u967d\u6027\u3001\u3046\u3064\u75c5\/\u4e0d\u5b89\u969c\u5bb3\u306e\u75c7\u72b6\u306e\u91cd\u75c7\u5ea6\u304c\u4f4e\u3044\u3001\u82e5\u5e74\u3067\u3042\u3063\u305f\u3002<\/p>\n<p>\uf06e Conclusion\uff1a<br \/>\n\u30eb\u30fc\u30c1\u30f3\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u3068\u3046\u3064\u75c5\u306e\u6cbb\u7642\u958b\u59cb\u5f8c\u30013\u56de\u4ee5\u4e0a\u30d5\u30a9\u30ed\u30fc\u30a2\u30c3\u30d7\u3055\u308c\u3066\u3044\u308b\u60a3\u8005\u306f\u5bdb\u89e3\u7387\u304c\u9ad8\u304b\u3063\u305f\u304c\u3001\u30b1\u30a2\u306e\u8131\u843d\u7387\u306e\u9ad8\u3055\u306f\u3001\u30a2\u30a6\u30c8\u30ab\u30e0\u306b\u60aa\u5f71\u97ff\u3092\u53ca\u307c\u3059\u91cd\u5927\u306a\u554f\u984c\u3067\u3042\u308b\u3002<\/p>\n<p>\u80cc\u666f\uff1a<br \/>\n\u27a2 \u5927\u3046\u3064\u75c5\u306fUS\u3067\u306f\u6210\u4eba\u306e5-10%\u3092\u5360\u3081\u308b\u3002\u305d\u306e\u534a\u6570\u306f\u3046\u3064\u75c5\u3068\u8a3a\u65ad\u3055\u308c\u3066\u3044\u306a\u3044\u3002\u9069\u5207\u306a\u6cbb\u7642\u3092\u53d7\u3051\u3066\u3044\u308b\u306e\u306f1\/5\u4ee5\u4e0b\u3002<br \/>\n\u3086\u3048\u306b\u4e00\u822c\u4eba\u53e3\u3092\u5bfe\u8c61\u306b\u3046\u3064\u75c5\u306e\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u3092\u884c\u3046\u3053\u3068\u304c\u63a8\u5968\u3055\u308c\u3066\u3044\u308b\u30022015\u5e74\u306b\u5916\u6765\u3067\u3046\u3064\u75c5\u3068\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u3055\u308c\u305f\u306e\u306f3%\u306e\u307f\u3002<\/p>\n<p>\u27a2\u30d7\u30e9\u30a4\u30de\u30ea\u30b1\u30a2\u30af\u30ea\u30cb\u30c3\u30af\u3067\u6cbb\u7642\u3055\u308c\u305f\u3046\u3064\u75c5\u60a3\u8005\u306e\u30a2\u30a6\u30c8\u30ab\u30e0\u306f\u3001measurement-basedcare(MBC)\u306b\u5247\u3063\u3066\u884c\u308f\u308c\u305f\u5834\u5408\u3001\u7cbe\u795e\u79d1\u3067\u306e\u6cbb\u7642\u3068\u540c\u7b49\u3067\u3042\u308b\u3002<\/p>\n<p>\u27a2 Measurement-based care\u30a2\u30d7\u30ed\u30fc\u30c1\uff1a<br \/>\n(1)\u6a19\u6e96\u5316\u3055\u308c\u305f\u75c7\u72b6\u3084\u526f\u4f5c\u7528\u3001\u6cbb\u7642\u306e\u30a2\u30c9\u30d2\u30a2\u30e9\u30f3\u30b9\u306e\u8a55\u4fa1<br \/>\n(2)\u6cbb\u7642\u306b\u5bfe\u3059\u308b\u73fe\u5834\u3067\u306e\u610f\u601d\u6c7a\u5b9a<br \/>\n(3)\u7d99\u7d9a\u7684\u306a\u30d5\u30a9\u30ed\u30fc\u30a2\u30c3\u30d7<br \/>\n(4)\u610f\u601d\u6c7a\u5b9a\u3092\u30b5\u30dd\u30fc\u30c8\u3059\u308b\u305f\u3081\u306eclinician\u3078\u306e\u30d5\u30a3\u30fc\u30c9\u30d0\u30c3\u30af<br \/>\n\u304b\u3089\u6210\u308b\u3002\u901a\u5e38\u306e\u30b1\u30a2\u3068\u6bd4\u8f03\u3057\u30662\u500d\u306e\u5bdb\u89e3\u7387\u3068\u898b\u8fbc\u3081\u308b\u3068\u3055\u308c\u3001\u3046\u3064\u75c5\u306e\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u306b\u3082\u63a1\u7528\u3055\u308c\u3066\u3044\u308b\u3002<br \/>\n\u4e3b\u306b\u60a3\u8005\u306e\u81ea\u5df1\u5831\u544a\u306b\u3088\u308b\uff08\u81ea\u8a18\u5f0f\u8cea\u554f\u7968\u3092\u6d3b\u7528\uff09\u3002<\/p>\n<p>\u27a2 Quality-improvement project\uff1a\u3046\u3064\u75c5\u306f\u6162\u6027\u75be\u60a3\u3067\u3042\u308a\u3001\u30a8\u30d3\u30c7\u30f3\u30b9\u306b\u57fa\u3065\u3044\u305f\u3046\u3064\u75c5\u8a3a\u7642\u3092\u30d7\u30e9\u30a4\u30de\u30ea\u30b1\u30a2\u3067\u65b0\u3057\u3044\u30b9\u30bf\u30f3\u30c0\u30fc\u30c8\u3078\u3002<br \/>\n\u30a6\u30a7\u30d6\u30d9\u30fc\u30b9\u306e\u30a2\u30d7\u30ea\u3092\u6d3b\u7528\u3057\u3066\u304a\u308a\u3001\u305d\u308c\u306b\u3088\u3063\u3066(1)\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u3001(2)\u3046\u3064\u75c5\u3068\u8a3a\u65ad\u3055\u308c\u305f\u60a3\u8005\u306e\u75c7\u72b6\u306e\u30e2\u30cb\u30bf\u30ea\u30f3\u30b0\u3001(3)clinician\u306b\u5bfe\u3057\u3066MBC\u3092\u30ac\u30a4\u30c9\u3059\u308b<\/p>\n<p>\u27a2 Clinician\uff1a\u5185\u79d1\u533b\u3001\u5bb6\u5ead\u533b\u3001\u5c0f\u5150\u79d1\u533b\u3001physician assistants\u3001advanced practice nurses<\/p>\n<p>\u3010\u958b\u50ac\u65e5\u30112019\u5e749\u67084\u65e5\uff08\u6c34\uff09<\/p>\n","protected":false},"excerpt":{"rendered":"<p>\uff0d\u6587\u732e\u540d\uff0d Manish K. Jha, MD, et al. A structured approach to detecting and treating depression in primary care: Vi &hellip; <a href=\"https:\/\/www.hcfm.jp\/journal\/?p=1745\" class=\"more-link\">\u7d9a\u304d\u3092\u8aad\u3080 <span class=\"screen-reader-text\">\u30d7\u30e9\u30a4\u30de\u30ea\u30b1\u30a2\u306b\u304a\u3051\u308b\u3046\u3064\u75c5\u306e\u75ab\u5b66<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[15,22],"tags":[],"class_list":["post-1745","post","type-post","status-publish","format-standard","hentry","category-15","category-22"],"_links":{"self":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/1745","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1745"}],"version-history":[{"count":2,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/1745\/revisions"}],"predecessor-version":[{"id":1754,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/1745\/revisions\/1754"}],"wp:attachment":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1745"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1745"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1745"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}