Depression is a global issue that primarily affects the adult population. The condition is prevalent among adults, but doctors use drugs and evidence-based methods as treatment strategies. The project aims to establish the outcomes of using pharmacotherapy and psychotherapy techniques. Therefore, the researcher has analyzed previous sources systematically to identify the strategies that decrease the depressive symptoms of the patients. Sixteen sources (seven experimental, eight qualitative, and one non-experimental) were analyzed and verified using the John Hopkins EBP level and tool (Dang & Dearholt, 2018). There is adequate and moderately considerable evidence to provide that pharmacotherapy and psychotherapy techniques are useful or credible strategies for the medication of depression. Thus, healthcare providers should consider implementing the approaches.
HCIP Project
Depression is a primary health issue among adults across the world. It is essential to identify the interventions for the disease to administer the proper strategies to reduce the prevalence worldwide. The condition can be managed using drugs and evidence-based practices. The paper provides a comprehensive literature review conducted systematically to establish the state of science regarding two advanced nursing interventions focusing on managing depression: pharmacotherapy and psychotherapy.
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Background
Depression is a prevalent health challenge among adults in the community. The disease cause severe consequences such as committing suicide, addiction, self-harm, health challenges, weak interactions, and negligent behavior (McLaughlin, 2011) . The first step in diagnosing depression is to identify the signs and their persistence. The primary symptoms include anxiety, sleeping challenges, loss of appetite, suicidal thoughts, confusion, guilt, and restlessness (McLaughlin, 2011) . Subsequently, physicians can examine the physical causes of the signs. The medical provider will determine the factors after a physical analysis, lab tests, or interviews with the victims. The depression rates are different regarding age, gender, earning, and health practices. Depression is higher among women as compared to men (McLaughlin, 2011) . Depression is serious health issue that needs to be addressed.
Significance
Significance to the patients and families. Depression has a psychological, financial, and social impact on the families of the victims. Also, the condition affects the patient’s ability to perform tasks and mental health deteriorates. The family of the victim is affected psychologically and emotionally because they bear the burden of the victim (McLaughlin, 2011) . The household has the responsibility of meeting the medical expenses because the victim cannot work. The social life of the victim is affected because they are unable to express their feelings or thoughts due to depressive signs. Depression increases morbidity and mortality levels in the families (McLaughlin, 2011) . Therefore, the condition affects the daily and overall quality of life of the household members.
Significance of the healthcare system. The hospitals treat about 25 million patients annually (Bock et al., 2014). The care settings that offer mental assistance are located in different areas across America. Therefore, patients can access medical assistance at any point. The medical expenses for treating depression in America amount to $ 210 billion a year (Bock et al., 2014). The healthcare structure encounters problems in financial reimbursement and pay-for-performance which are not addressed. Researchers indicate that between 10 to 40% of depressed patients are re-admitted in the care settings due to the effects of treatment. However, there are no cases on admission to the hospitals due to depression (Bock et al., 2014). The APRNs are responsible for screening patients with mental disorders and administer the correct medication. Also, the APRNs can refer the victims to behavioral professionals for earlier detection of the condition. As a result, it prevents delays in analysis and prescription (Bock et al., 2014). Depression has affected the operation of the healthcare system in the United States.
Significance for the community. Depression decreases the productivity levels of the affected families and patients. However, the health problem has an indirect effect on crime in the society. The patient or household members can be forced to engage in criminal activities to meet the medical costs including drugs. The death and morbidity rates can increase if the American community does not have adequate resources to manage the condition. Managing the disease can be costly to privately insured citizens. However, Medicare costs increase due to the rise in depression cases. The nation spends half-trillion on the tax to meet the Medicaid expenses.
Summary of the Problem
Adults suffer from depression which affects their families, communities, and the medical sector. Also, the prevalence of the mental condition influences the spending rates of the state. It is critical to assess the proper techniques to mitigate the consequences of the illness. The HCIP project will provide insights into the subject and health sector. Also, depression is a current issue, and there is a possibility the levels will increase after several years. Establishing the right medication process is significant in reducing the victim rates.
Current Approaches to Treatment
The desired outcomes include suggesting treatments and courses or actions that are useful in enhancing the depressed patient’s health. The aim is to make decisions that can contribute to the management and treatment of depression in the medical sector. The evidence-based for managing depression include behavioral and psychodynamic interventions. However, the cognitive-behavioral practice improves the health of the depressed person as compared to the psychodynamic approach (Driessen et al., 2017). In most cases, health professionals use the cognitive behavioral strategy as a supplement to pharmacological and psychotherapy intervention methods (Nakagawa et al., 2017). Many scholars have researched the proper intervention methods for treating and managing depression.
Pharmacotherapy and psychotherapy are the primary interventions that have been studied by scholars due to their usefulness in managing depression. Hollon et al. (2016) found that pharmacotherapy strategies such as administration of anti-depressants to persons with major depressive orders assist in recovery. Besides, the scholars claimed that the treatment is useful when the medical providers combine it with cognitive methods to enhance full recovery. Boulenger, Loft, & Olsen (2014) revealed that Vortioxetine is helpful in the medication on individuals with acute stress. The scholars discovered that placebo was not tolerant in the administration of therapy among adults. Dunlop et al. (2017) found that duloxetine is useful in reducing the primary depressive signs among individuals with severe disorders. Kessler et al. (2018) found that a combination of anti-depressants helps treat acute mental illnesses. The researchers suggested that physicians can use MIR RCT to treat depression. LeBlance et al. (2015) revealed that anti-depressants could treat depression if the patients and medical providers discuss the medications that provide a positive outcome. The writers suggested that the DMC model is a proper strategy for making decisions. Also, Vermeiden (2018) supported the idea that drugs can reduce acute depression signs. The writer claims that doctors should administer two medications in the management of stress. However, the physician can add lithium if the two anti-depressants do not reduce the symptoms. Medications can be useful in the treatment of depression, but some researchers perceive that evidence-based methods have a long-term effect on the health of the patient.
Cooper et al. (2016) revealed that psychotherapy techniques reduce the stress symptoms and have a long-lasting effect on the patient. The researchers explained that behavioral and home-based strategies are essential in full recovery. Button et al. (2015) claimed that psychotherapy approaches could be used as a supplement if the victim is resistant to medications. Also, Souza et al. (2016) supported the argument that interpersonal therapy can reduce the signs to improve the patient’s health. Lemmens et al. (2017) claimed that psychotherapy methods decrease the acute signs among the victims. The scholars revealed that useful types focused on improving the patient’s conduct. Nakagwa et al. (2017) added that psychotherapy approaches could be combined with medications for the victim to achieve full recovery. Mantani, Kato, & FurukawaToshi (2017) argued that medicine could reduce the stress sign but cannot cure the condition. The writers revealed that the smartphone CBT approach could cure depression. Scholars claim that psychotherapy techniques can cure stress because they have a long-term impact on the victim’s health.
The PICO question for the project is
Among adults with depression how effective are the pharmacotherapy interventions compared to psychotherapy methods in reducing the depressive symptoms during the medication and recovery time?
Intervention/ Treatment Strategy-Pharmacotherapy
Pharmacotherapy involves the prescription of medicine to the patients after the healthcare provider establishes the diagnosis results. The physicians administer medications on depressed patients because they expect to reduce the signs and manage the condition. The primary medications for controlling the disease include SSRIs and SNRIs. The physician can also administer two medicines to handle the situation effectively. The supplemental drugs include mirtazapine or placebo. At times, healthcare providers use evidence-based practices such as CBT to enhance the victim’s recovery. It is critical to consider APRNs such as the accessibility of medicine to the patients to control the illness. The medications have side effects such as fatigue and nausea. The medicines are affordable to middle and high-income earners. However, low-income families can enroll for relief programs to acquire financial support where they can purchase the medications.
Comparison/ Intervention Strategy-Psychotherapy
Psychotherapy interventions focus on the improvement of the victim’s behavior and responses to ensure the patient achieves full recovery. The medical providers administer the methods with the expectation that the victim will not exhibit any symptoms. In some cases, the doctors provide use the practices to supplement the usefulness of the medications. Also, cognitive behavioral strategies are combined with the EBP to reduce the signs. It is critical to consider the cultural beliefs of the patients before implementing the practices. Besides, the EBPs are cheap, and some are free. Also, there are no side effects of the EBP methods.
Purpose
The primary purpose of the systematic analysis is to establish the science regarding pharmacotherapy methods and psychotherapy intervention for the treatment of depression in adults. Specific aims were to:
Compare the effects of pharmacotherapy and psychotherapy on decreasing depressive symptoms in adults.
Formulate evidence-based recommendations for practice regarding the use of pharmacotherapy and psychotherapy for the treatment of depression in adults.
Formulate recommendations for future research aimed at the treatment of depression in adults.
Framework
The tidal model (TM) ( Barker & Buchanan-Barker, 2010 ) provided a conceptual foundation for this project. The overriding premise of this theory is that mental distressed victims should be assisted in recovering by giving them a voice. Fundamental concepts of the tidal model, relevant to this project include self, world, and other domains. Self domain is defined as the situation where people experience the world. World domain is defined as the context where people enclose their stories. Others domain is defined as the relationships that an individual has including the past, current, and future. According to the tidal model, the role of the nurse is to understand the experiences of the victim and assist to create a security plan. A fundamental proposition of the tidal model relevant to this project is that it is critical to identify the mental health problem before assisting the patient.
In this evidenced-based project, depression mirrors the tidal model concept of self and others domain. The project intervention, pharmacotherapy and psychotherapy, constitute the tidal model components self and world domain. The project outcome of reducing depressive symptoms, reflect the tidal model component self and world domain. In this project, the author posited that background and behaviors affect mental health in adults, which mirrors the relationship between people and experiences proposed in the tidal model.
References
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