An Indian-origin psychiatry researcher at the University of Texas Southwestern Medical Center has developed a computerized treatment system to assist doctors dealing with cases of depression.
Dr. Madhukar Trivedi is currently testing his treatment system in a Nashville, Tenn.-based mental and behavioral health care organization.
He attributes the creation of this system to the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study, which was the largest study ever conducted on the treatment of major depressive disorder.
"This is exciting because although this project incorporates elements of STAR*D and cutting-edge algorithms developed and refined by UT Southwestern researchers over decades, it moves way beyond that," said Dr. Trivedi.
He pointed out that STAR*D provided evidence for step-by-step guidelines to address treatment-resistant depression, and found that half of depressed patients became symptom-free or had major improvement after the first two treatments with medication.
Similarly, he added, the new computer software could provide a step-by-step guide to assist doctors as they treated patients.
Dr. Trivedi revealed that the program prompted doctors with more specific questions that went beyond "Do you feel better?" after taking medication.
"This computerized system gives doctors assistance at the time that they are seeing the patient. It's like walking with someone learning to ride a bike versus just sitting there and telling them how to ride," he said.
He further pointed out that the administration of depression treatment was often inadequate.
"Major depressive disorder treatment lags behind the care of other chronic diseases. It's not like an infection where you treat for a short time and that's it," he said.
He said that doctors would generally not ask follow-up questions of their patients or routinely use systematic measurement tools to gauge progress.
"My interest is in helping clinicians, researchers and patients in real-practice settings. It's a different magnitude of complexity when you go to a busy clinical practice setting away from academic centers," Dr. Trivedi said.
Even in the STAR*D study, only about 50 depression patients from each test-site clinic were selected to participate, he said.
"Studying depression in a very small setting with an isolated patient population was important as we sought to answer certain essential questions, but it is different from the regular practice of doctors and patients," he said.
Dr. Trivedi also revealed that the current research project would include all patients with depression at study sites .He said that the number of patients could reach 8,000, depending on how many are scheduled for treatment with Centerstone, a nonprofit provider of community-based behavioural health services that has partnered with Dr. Trivedi.
"We know depression is similar to other chronic illnesses and yet treatable. We know we have a lot of options. While we are still developing other treatment alternatives, it's important to make sure that the research we have now works in the real world. This work with Centerstone will help ensure that depressed patients receive the most effective treatment regime available," Dr. Trivedi said.