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  • Practice based education did not increase recognition of depression by primary care physicians nor improve the outcome of depression

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Quality improvement
Practice based education did not increase recognition of depression by primary care physicians nor improve the outcome of depression

https://doi.org/10.1136/ebm.5.5.158

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    (2000) Lancet 355, 185. Thompson C, Kinmonth AL, Stevens L, et al.. Effects of a clinical-practice guideline and practice-based education on detection and outcome of depression in primary care: Hampshire Depression Project randomised controlled trial.. Jan 15;. :. –91.
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 QUESTION: In primary care, is an education programme based on a clinical practice guideline effective in improving the recognition and outcome of depression?

    Design

    Cluster randomised (allocation concealed*), unblinded,* controlled trial with 6 month follow up.

    Setting

    59 primary care practices in a health district in England, UK.

    Patients

    21 409 patients attending the clinics of 152 physicians were screened. Exclusion criteria were being <16 years of age or too unwell to complete the questionnaire.

    Intervention

    29 practices (3 withdrew leaving 26 practices with 64 physicians) were allocated to the education group, and 30 (1 was excluded leaving 29 practices with 88 physicians) were allocated to the control group. Education using a clinical practice guideline (tricyclic antidepressants recommended as first line treatment and physicians advised to aim for a dose of 150 mg) was provided in 2 parts by a team. Part 1 consisted of 4 hours of seminars, in groups of up to 20, at the beginning of …

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    Footnotes

    • Sources of funding: Medical Research Council; South and West Research and Development Directorate; Southampton Community Health Services Trust.

    • For correspondence: Professor C Thompson, Community Clinical Sciences Research Division, Department of Mental Health, University of Southampton, Royal South Hants Hospital, Brinton's Terrace, Southampton SO14 0PE, UK. Fax +44 (0)2380 234243.

    • Abstract and commentary also appear in Evidence-Based Mental Health.

    • ↵* See glossary.