A Survey of Primary Care Provider Attitudes and Behaviors Regarding Treatment of Adult Depression (original) (raw)

Depression Treatment in Primary Care

Background: Depression costs the United States $40 billion annually. Primary care physicians play a key role in the identification and treatment of depression. This study focused on the treatment options recommended by physicians and whether physicians were following the recommended treatment guidelines.

Challenges of implementing depression care managements in the primary care setting

2006

Empirical evidence shows that care management is an effective tool for improving depression treatment in primary care patients. However, several conceptual and practical issues have not been sufficiently addressed. This article explores questions concerning the scope of care management services within the chronic illness care model; optimal ways to identify depressed patients in the primary care setting; responsibilities and desirable qualifications of depression care managers; the location and manner in which care managers interact with patients; costs of services provided by care managers; and the level of supervision by mental health specialists that is necessary to ensure quality care. KEY WORDS: care management; depression; primary care. BACKGROUND Although evidence-based guidelines for the treatment of depression in primary care were pub-lished as early as 1993 by the Agency for Health Care Policy and Research, depression continues to be underdiagnosed and inadequately treated...

Clinic-Level Process of Care for Depression in Primary Care Settings

Administration and Policy in Mental Health and Mental Health Services Research, 2009

Multi-component models for improving depression care target primary care (PC) clinics, yet few studies document usual clinic-level care. This case comparison assessed usual processes for depression management at 10 PC clinics. Although general similarities existed across sites, clinics varied on specific processes, barriers, and adherence to practice guidelines. Screening for depression conformed to guidelines. Processes for assessment, diagnosis, treatment, and follow-up varied to different degrees in different clinics. This individuality of usual care should be defined prior to quality improvement interventions, and may provide insights for introducing or tailoring changes, as well as improving interpretation of evaluation results.

Challenges of Implementing Depression Care Management in the Primary Care Setting

Administration and Policy in Mental Health, 2006

Empirical evidence shows that care management is an effective tool for improving depression treatment in primary care patients. However, several conceptual and practical issues have not been sufficiently addressed. This article explores questions concerning the scope of care management services within the chronic illness care model; optimal ways to identify depressed patients in the primary care setting; responsibilities and desirable qualifications of depression care managers; the location and manner in which care managers interact with patients; costs of services provided by care managers; and the level of supervision by mental health specialists that is necessary to ensure quality care.

Managing depression in primary care: community survey

Canadian family physician Médecin de famille canadien, 2006

To investigate family physicians' practice patterns for managing depression and mental health concerns among adolescent and adult patients. Cross-sectional survey. London, Ont, a mid-sized Canadian city. One hundred sixty-three family physicians identified through the London and District Academy of Medicine. Practice patterns for managing depression, including screening, pharmacotherapy, psychotherapy, shared care, and training needs. Response rate was 63%. Family physicians reported spending a substantial portion of their time during patient visits (26% to 50%) addressing mental health issues, with depression being the most common issue (51% to 75% of patients with mental health issues). About 40% of respondents did routine mental health screening, and 60% screened patients with risk factors for depression. Shared care with mental health professionals was common (care was shared for 26% to 50% of patients). Physicians and patients were moderately satisfied with shared care, but...

Improving depression outcomes in community primary care practice

Journal of General Internal Medicine, 2001

OBJECTIVE: To determine whether redefining primary care team roles would improve outcomes for patients beginning a new treatment episode for major depression. DESIGN: Following stratification, 6 of 12 practices were randomly assigned to the intervention condition. Intervention effectiveness was evaluated by patient reports of 6-month change in 100-point depression symptom and functional status scales.

Primary Care Physicians' Evaluation and Treatment of Depression

Medical Care Research and Review, 2008

Little is known about how patient and primary care physician characteristics are associated with quality of depression care. The authors conducted structured interviews of 404 randomly selected primary care physicians after their interaction with CD-ROM vignettes of actors portraying depressed patients. Vignettes varied along the dimensions of medical comorbidity, attributions regarding the cause of depression, style, race/ethnicity, and gender. Results show that physicians showed wide variation in treatment decisions; for example, most did not inquire about suicidal ideation, and most did not state that they would inform the patient that there can be a delay before an antidepressant is therapeutic. Several physician characteristics were significantly associated with management decisions. Notably, physician age was inversely correlated with a number of quality-of-care measures. In conclusion, quality of care varies among primary care physicians and appears to be associated with phys...