| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
British Medical Bulletin 57:193-206 (2001)
© 2001 Oxford University Press
Treatment delivery and guidelines in primary care
Depression and public health
Community Clinical Sciences Division, University of Southampton, Southampton, UK
Because depressive illness is so prevalent, the majority of patients are managed in primary care, without recourse to specialist services. Primary care management is seen to fall short of the standards set in secondary care, but unfortunately there is as yet relatively little evidence from primary care to guide management in this distinctive patient population. Guidelines have been introduced as a means of quality management, and their value in improving care has been assessed in trials. To date, the benefits of the implementation of guidelines have been marginal at best. By contrast, strategies which improve the access of patients to specialist services do seem to be beneficial. There is also evidence that such strategies may be associated with ‘cost-offset’. Choice of antidepressant medication for maximum cost benefit should also be informed by an evidence base, which is beginning to be accumulated. Further research on this topic in the primary care context is still needed.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  O. Morgan, C. Griffiths, and A. Majeed Antidepressant prescribing and changes in antidepressant poisoning mortality and suicide in England, 1993-2004 J. Public Health Med., March 1, 2008; 30(1): 60 - 68. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 The MaGPIe Research Group The treatment of common mental health problems in general practice Fam. Pract., February 1, 2006; 23(1): 53 - 59. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Maxwell Women's and doctors' accounts of their experiences of depression in primary care: the influence of social and moral reasoning on patients' and doctors' decisions Chronic Illness, March 1, 2005; 1(1): 61 - 71. [Abstract] [PDF]
|
|
|
|
 |
|
 C. Chew-Graham, R. Baldwin, and A. Burns Treating depression in later life BMJ, July 24, 2004; 329(7459): 181 - 182. [Full Text] [PDF]
|
|
|
|
 |
|
 R. Thomas-MacLean and J. M. Stoppard Physicians' Constructions of Depression: Inside/Outside the Boundaries of Medicalization Health (London) , July 1, 2004; 8(3): 275 - 293. [Abstract] [PDF]
|
|
|
|
 |
|
 S M Campbell, J Robison, A Steiner, D Webb, and M O Roland Improving the quality of mental health services in Personal Medical Services pilots: a longitudinal qualitative study Qual. Saf. Health Care, April 1, 2004; 13(2): 115 - 120. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Gilbody, P. Whitty, J. Grimshaw, and R. Thomas Educational and Organizational Interventions to Improve the Management of Depression in Primary Care: A Systematic Review JAMA, June 18, 2003; 289(23): 3145 - 3151. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S M Gilbody, P M Whitty, J M Grimshaw, and R E Thomas Improving the detection and management of depression in primary care Qual. Saf. Health Care, April 1, 2003; 12(2): 149 - 155. [Abstract] [Full Text] [PDF]
|
|