Development of a Provider Treatment Toolkit for Postpartum Depression

The purpose of this project was to focus provider efforts on the diagnosis, treatment and referral for postpartum depression (PPD) in the clinical setting through the use of a PPD treatment toolkit. The objectives of this project were to develop a PPD treatment toolkit that provided assessment tools, coding/charting guides, identification of available treatment options, a referral list of available resources and a chart of the most common medications/dosages. This toolkit was disseminated to large CNM/WHNP practice and at the Regional Women's Health and Midwifery Conference. Postpartum depression is a major depressive disorder occurring during the first year after giving birth and is one of the most common complications during the postpartum period. Research has shown that PPD can contribute to reduced maternal physical and emotional health leading to poor health outcomes in children that may result in long-term delays in cognitive and emotional development. Despite these known adverse effects on maternal and child health, PPD is still under-diagnosed, leading to under treatment. In order to successfully treat PPD, healthcare providers who care for women in the postpartum period need to be knowledgeable about treatment options and the resources available in their community. The toolkit was developed though a review of the literature and online resources, along with suggestions from content experts. This toolkit includes a screening tool; treatment algorithm; brief and immediate office intervention recommendations; information on pharmacologic and non-pharmacologic treatment, billing and coding; and a handout for patients that includes warning signs, symptoms, and emergency help. The toolkit was presented to a large CNM/WHNP practice. It was evaluated for implementation and applicability within the practice by nine providers who gave suggestions for revision, and the final toolkit was created and disseminated to the entire practice. Clinical implications for using this toolkit include improved diagnosis and treatment of PPD. Its contents are easily available and save provider search time for resources, billing, and patient handouts. Toolkit use will also provide clarity and consistency in coding for visits and provide a means for extracting EMR data for future research.