GP training and guidelines implementation improves depression care, but training alone does not help, according to new systematic review


Healthcare providers are always on the look out for ways to improve the detection and diagnosis of depression in primary care. It’s a prevalent illness amongst Europeans with 6.9% of people suffering from it in any 12-month period.

We know that 50-70% of depressed patients consult their GP during an episode, so improving systems for recognising and treating these patients should be a priority.

Two well trodden paths over recent years have been trying to improve training for health professionals and implementing local evidence-based pathways and guidelines.

This systematic review (available in full-text on BioMed Central) looked at research studies providing training of general practitioners that have been published since 1999. The researchers conducted a systematic search and found relatively few (11) randomised studies evaluating the effect of primary care physician education on health outcomes of patients. They commented that:

The research focus has shifted to more complex interventions encompassing collaborative and stepped care approaches by introducing mental health specialists to the primary care setting.

Here’s what they found in this review:

  • Training primary care staff alone (even in a specific intervention like CBT) did not result in improved patient outcomes
  • Training primary care staff and also implementing guidelines and more complex interventions did bring a significant reduction in depression

The authors concluded:

This is the first overview of randomized controlled trials introducing GP training for depression care. Provider training by itself does not seem to improve depression care; however, if combined with additional guidelines implementation, results are promising for new-onset depression patient samples. Additional organizational structure changes in form of collaborative care models are more likely to show effects on depression care.

Sikorski C, Luppa M, Konig HH, van den Bussche H, Riedel-Heller SG. Does GP training in depression care affect patient outcome? – A systematic review and meta-analysis. BMC Health Serv Res. 2012 Jan 10;12(1):10. [Epub ahead of print]

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Andre Tomlin

André Tomlin is an Information Scientist with 20 years experience working in evidence-based healthcare. He's worked in the NHS, for Oxford University and since 2002 as Managing Director of Minervation Ltd, a consultancy company who do clever digital stuff for charities, universities and the public sector. Most recently André has been the driving force behind the Mental Elf and the National Elf Service; an innovative digital platform that helps professionals keep up to date with simple, clear and engaging summaries of evidence-based research. André is a Trustee at the Centre for Mental Health and an Honorary Research Fellow at University College London Division of Psychiatry. He lives in Bristol, surrounded by dogs, elflings and lots of woodland!

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