Primary Care Physicians' Approach to Depressive Disorders: Effects of Physician Specialty and Practice Structure

Abstract

A substantial proportion of PCPs report diagnostic and treatment approaches that are consistent with high-quality care. Differences in approach were associated more with specialty than with type of depressive disorder or degree of capitation. Quality improvement efforts need to (1) be tailored for different physician specialties, (2) emphasize the importance of differentiating major depression from other depressive disorders and tailoring the treatment approach accordingly, and (3) address organizational barriers to best practice and knowledge gaps about depression treatment.

Comfort of General Internists and General Pediatricians in Providing Care for Young Adults with Chronic Illnesses of Childhood

“…[16][17][18] We hypothesized that factors such as physician experience (e.g., treating specific conditions during residency and practice), physician characteristics (e.g., board certification, years in practice), practice characteristics (e.g., practice type) and available resources (e.g., access to disease center, services such as social work or nutrition, and subspecialists) would be associated with physician treatment comfort. [19][20][21] We also hypothesized that internists with higher treatment comfort would be more willing to accept responsibility for primary care delivery of young adults with childhood onset chronic conditions.…”

Implementation of Guideline-Based Care for Depression in Primary Care

“…Antidepressant Medications. Antidepressants are commonly prescribed by PCPs (Olfson et al, 2002;Williams et al, 1999). However, this treatment's implementation is influenced by fiscal as well as clinical factors.…”

Potential Impact of Incorporating a Patient-Selected Support Person into mHealth for Depression

“…2,3 Although telephone care management is an evidence-based and cost-effective strategy for improving antidepressant medication adherence, 4 its implementation is often not feasible in resource-constrained settings due to high numbers of undertreated patients and limited numbers of trained providers. 5 Mobile health (mHealth) services such as interactive voice response (IVR) telephone calls, smartphone applications, and text messaging may help to address these problems. In IVR calls, patients respond to prerecorded queries using either their telephone keypad or voice recognition technology.…”