Adherence to evidence-based guidelines for depression and anxiety disorders is associated with recording of the diagnosis

Smolders, Mirrian; Laurant, Miranda; Verhaak, Peter; Prins, Marijn A.; Marwijk, Harm van; Penninx, Brenda W. J. H.; Wensing, Michel; Grol, Richard

doi:10.1016/j.genhosppsych.2009.05.011

Cited by 73 publications

(71 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…An additional analysis of our data indicates that the likelihood of receiving an adequate treatment is higher among patients with a valid diagnosis, as reported previously (Smolders et al, 2009). However, we did not detect any effect of these two variables in clinical outcomes at one-month or three-month follow-ups.…”

Section: Treatment Adequacysupporting

confidence: 87%

Diagnostic accuracy and adequacy of treatment of depressive and anxiety disorders: A comparison of primary care and specialized care patients

Castro-Rodríguez

Olariu

Garnier-Lacueva

et al. 2015

Journal of Affective Disorders

View full text Add to dashboard Cite

Section: Treatment Adequacysupporting

confidence: 87%

Diagnostic accuracy and adequacy of treatment of depressive and anxiety disorders: A comparison of primary care and specialized care patients

Castro-Rodríguez

Olariu

Garnier-Lacueva

et al. 2015

Journal of Affective Disorders

View full text Add to dashboard Cite

“…A study among primary care patients with a depressive or anxiety disorder in The Netherlands also showed that symptom severity was unrelated to guideline-concordant care, unless the general practitioner had diagnosed them as such (Smolders et al 2009). …”

Section: Discussion Of the Research Findingsmentioning

confidence: 99%

Common mental disorder severity and its association with treatment contact and treatment intensity for mental health problems

et al. 2013

View full text Add to dashboard Cite

Although CMD severity was related to treatment contact, only 39.0% of severe cases received MHC. At the same time, 40.3% of MHC users did not have a 12-month disorder. Increasing levels of treatment intensity ranged from 51.6% to 13.0% in GMC and from 81.4% to 51.1% in MHC. CMD severity was related to treatment intensity in MHC but not in GMC. Sociodemographic characteristics were not significantly related to having experienced the highest level of treatment intensity in MHC. CONCLUSIONS. Mental health treatment in the GMC sector should be improved, especially when policy is aimed at increasing the role of primary care in the management of mental health problems.

show abstract

“…The following data were collected for each patient included in the study,: number and type of contacts, International Classification of Primary Care (ICPC) codes [37], prescribed medication (type and dose), duration of prescription, and referrals. Our earlier NESDA paper [38] described the degree to which GPs adhered to the evidence-based DCGP clinical depression and anxiety guidelines in the delivery of care for their anxiety and depression patients [15,16]. Based on the care they had received, patients were divided into two groups, i.e.…”

Section: Methodsmentioning

confidence: 99%

Outcomes for depression and anxiety in primary care and details of treatment: a naturalistic longitudinal study

et al. 2011

View full text Add to dashboard Cite

BackgroundThere is little evidence as to whether or not guideline concordant care in general practice results in better clinical outcomes for people with anxiety and depression. This study aims to determine possible associations between guideline concordant care and clinical outcomes in general practice patients with depression and anxiety, and identify patient and treatment characteristics associated with clinical improvement.MethodsThis study forms part of the Netherlands Study of Depression and Anxiety (NESDA).Adult patients, recruited in general practice (67 GPs), were interviewed to assess DSM-IV diagnoses during baseline assessment of NESDA, and also completed questionnaires measuring symptom severity, received care, socio-demographic variables and social support both at baseline and 12 months later. The definition of guideline adherence was based on an algorithm on care received. Information on guideline adherence was obtained from GP medical records.Results721 patients with a current (6-month recency) anxiety or depressive disorder participated. While patients who received guideline concordant care (N = 281) suffered from more severe symptoms than patients who received non-guideline concordant care (N = 440), both groups showed equal improvement in their depressive or anxiety symptoms after 12 months. Patients who (still) had moderate or severe symptoms at follow-up, were more often unemployed, had smaller personal networks and more severe depressive symptoms at baseline than patients with mild symptoms at follow-up. The particular type of treatment followed made no difference to clinical outcomes.ConclusionThe added value of guideline concordant care could not be demonstrated in this study. Symptom severity, employment status, social support and comorbidity of anxiety and depression all play a role in poor clinical outcomes.

show abstract

Adherence to evidence-based guidelines for depression and anxiety disorders is associated with recording of the diagnosis

Abstract: Adherence to depression and anxiety guidelines can be improved, even when the general practitioner makes the diagnosis and records it. Data on actual health care delivery and quality of care provide insight and may be useful in developing quality improvement activities.

Cited by 73 publications

References 37 publications

Diagnostic accuracy and adequacy of treatment of depressive and anxiety disorders: A comparison of primary care and specialized care patients

Diagnostic accuracy and adequacy of treatment of depressive and anxiety disorders: A comparison of primary care and specialized care patients

Common mental disorder severity and its association with treatment contact and treatment intensity for mental health problems

Outcomes for depression and anxiety in primary care and details of treatment: a naturalistic longitudinal study

Contact Info

Product

Resources

About