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Training primary-care physicians to recognize, diagnose and manage depression: does it improve patient outcomes?

Abstract：

BACKGROUND:We developed a comprehensive, 20-hour training programme for primary-care physicians, that sought to improve their ability to detect, diagnose and manage depression. We evaluated the effects of physician training on patient outcomes, using a pre-post design. METHODS:In the pre-training phase of the study, we sampled 1834 consecutive patients of 17 primary-care physicians and evaluated 518 of these patients for the presence of depression. We measured outcomes of all patients with depression at 3 months and 1 year. The outcome measures were: severity of psychopathology; duration of depressive episode; and level of daily functioning. After the 17 physicians completed the training, we drew a new sample from their practices (498 of 1785 consecutive patients were evaluated for depression) and measured outcomes for the depressed patients. RESULTS:We found an effect of the training on short-term outcome, particularly for patients with a recent-onset depression. At 3-month follow-up depressed patients whose physicians had received training had less severe psychopathology and patients with recent-onset depression also showed higher levels of daily functioning than patients of the same physicians prior to the training. The patients with a recent-onset depression that was recognized by trained physicians had shorter depressive episodes, but this was not statistically significant. At 1-year follow-up, all training effects had faded away. CONCLUSIONS:Training primary-care physicians to recognize, diagnose and manage depression can improve short-term patient outcomes, especially for patients with a recent onset of depression. Patients suffering from a recurrent or chronic depression may need more specific interventions, both for acute treatment and long-term management.

journal_name

Psychol Med

journal_title

Psychological medicine

authors

Tiemens BG,Ormel J,Jenner JA,van der Meer K,Van Os TW,van den Brink RH,Smit A,van den Brink W

doi

10.1017/s0033291799008545

subject

Has Abstract

pub_date

1999-07-01 00:00:00

pages

833-45

issue

eissn

0033-2917

issn

1469-8978

journal_volume

pub_type

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Training primary-care physicians to recognize, diagnose and manage depression: does it improve patient outcomes?