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Does physician education on depression management improve treatment in primary care?

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Abstract

OBJECTIVE: To assess the effect of physician training on management of depression.

DESIGN: Primary care physicians were randomly assigned to a depression management intervention that included an educational program. A before-and-after design evaluated physician practices for patients not enrolled in the intervention trial.

SETTING: One hundred nine primary care physicians in 2 health maintenance organizations located in the Midwest and Northwest regions of the United States.

PATIENTS/PARTICIPANTS: Computerized pharmacy and visit data from a group of 124,893 patients who received visits or prescriptions from intervention and usual care physicians.

INTERVENTIONS: Primary care physicians received education on diagnosis and optimal management of depression over a 3-month training period. Methods of education included small group interactive discussions, expert demonstrations, role-play, and academic detailing of pharmacotherapy, criteria for urgent psychiatric referrals, and case reviews with psychiatric consultants.

MEASUREMENTS AND MAIN RESULTS: Pharmacy and visit data provided indicators of physician management of depression: rate of newly diagnosed depression, new prescription of antidepressant medication, and duration of pharmacotherapy. One year after the training period, intervention and usual care physicians did not differ significantly in the rate of new depression diagnosis (P=.95) or new prescription of antidepressant medicines (P=.10). Meanwhile, patients of intervention physicians did not differ from patients of usual care physicians in adequacy of pharmacotherapy (P=.53) as measured by 12 weeks of continuous antidepressant treatment.

CONCLUSIONS: After education on optimal management of depression, intervention physicians did not differ from their usual care colleagues in depression diagnosis or pharmacotherapy.

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Author information

Authors and Affiliations

  1. Research and Education, the Dean Foundation for Health, Middleton, Wis

    David J. Katzelnick MD

  2. Harvard Pilgrim Health Care, Boston, Mass

    Steven D. Pearson MD

  3. Center for Health Studies, Group Health Cooperative of Puget Sound, 1730 Minor Ave., Suite 1600, 98101, Seattle, WA

    Elizabeth H. B. Lin MD, MPH & Gregory E. Simon MD, MPH

Authors
  1. Elizabeth H. B. Lin MD, MPH
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  2. Gregory E. Simon MD, MPH
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  3. David J. Katzelnick MD
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  4. Steven D. Pearson MD
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Corresponding author

Correspondence to Elizabeth H. B. Lin MD, MPH.

Additional information

This study was made possible by a grant from Pfizer Pharmaceuticals Inc, New York, NY. We would like to thank Mr. Henry J. Henk and Ms. Kate Bond for their tireless efforts in data programming. Dr. Leslie Taylor contributed to the training of PCPs. We also are indebted to our primary care colleagues at Group Health Cooperative of Puget Sound and the Dean Foundation, whose support and enthusiasm were invaluable.

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Lin, E.H.B., Simon, G.E., Katzelnick, D.J. et al. Does physician education on depression management improve treatment in primary care?. J GEN INTERN MED 16, 614–619 (2001). https://doi.org/10.1046/j.1525-1497.2001.016009614.x

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  • DOI: https://doi.org/10.1046/j.1525-1497.2001.016009614.x

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