Outcomes in MEasurement-Based Treatment (COMET)

• Remission rate assessed by the Patient Health Questionnaire - 9 item (PHQ-9) instrument [ Time Frame: Measured at baseline ] [ Designated as safety issue: No ]
• Remission rate assessed by the Patient Health Questionnaire - 9 item (PHQ-9) instrument [ Time Frame: Follow-up upto 6 months ] [ Designated as safety issue: No ]

• Response rate assessed by the PHQ-9 instrument [ Time Frame: 6 months ] [ Designated as safety issue: No ]
• The medication prescribed including refills, dose titrations, switching and augmentation [ Time Frame: 6 months ] [ Designated as safety issue: No ]
• Health care utilizations including office visits, emergency room visits and hospitalization [ Time Frame: 6 months ] [ Designated as safety issue: No ]

• Health care utilization [ Time Frame: 6 month ] [ Designated as safety issue: No ]
• Antidepressant medication prescriptions and use [ Time Frame: 6 month ] [ Designated as safety issue: No ]
• Physician use of the MBT feedback [ Time Frame: 6 month ] [ Designated as safety issue: No ]

The primary objective for this study is to assess the impact of a measurement based treatment program (MBT) on Major Depressive Disorder (MDD) remission rates in patients whose primary care provider (PCP) receives monthly patient-reported depression severity reports compared to patients whose PCP does not receive monthly reports.

Primary care clinic

• Patients at the intervention sites
  The intervention sites will receive the results of the patient-reported depression severity collected during the phone interviews on a monthly basis. The patients in the intervention arm will be interviewed by phone once per month for 6 months.
• Patients at the usual care sites
  The usual care sites will receive the results of the patient-reported depression severity at the end of the study. Patients in the usual care arm will be interviewed at 3 months and 6 months post study enrollment.

Inclusion Criteria:

• Age ≥18 years old
• Diagnosis of major depressive disorder
• Prescribed a new prescription for an antidepressant medication on the date of study enrollment and currently taking the medication 'New' is defined as no antidepressant use in the previous 120 days
• Primary depression management is performed by the primary care provider
• Capable of self-management (i.e., taking medications and independently responding to follow-up contacts)
• Able to provide informed consent to participate
• Sufficient ability as judged by the physician to read, understand and complete survey instruments written in English and phone interviews spoken in English

Exclusion Criteria:

• History psychotic disorder or bipolar disorder
• Diagnosis of current postpartum depression
• Diagnosis of bereavement less than 8 weeks duration
• Currently pregnant
• History of suicide attempts or current suicide plan
• Need for psychiatric hospitalization at enrollment visit
• History of adjunctive treatments including electroconvulsive treatment (ECT), vagus nerve stimulation (VNS), transcranial magnetic stimulation (TMS), magnetic seizure therapy (MST), or deep brain stimulation (DBS)