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www.gu.s e Regular patient centred consultations and continuous use of a self-rating scale; effects on depression and quality of life. A randomized controlled study of structured treatment of mild to moderate depression in primary care Wikberg C, Björkelund C, Petersson E-L, Westman J, Baigi A Dept of Public Health and Community Medicine/Section of Primary Health Care, the Sahlgrenska Academy, University of Gothenburg.
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Transcript of Www.gu.se Regular patient centred consultations and continuous use of a self-rating scale; effects...
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Regular patient centred consultations and continuous use of a self-rating scale; effects on depression and quality of life. A randomized controlled study of structured treatment of mild to moderate depression in primary care
Wikberg C, Björkelund C, Petersson E-L, Westman J, Baigi A
Dept of Public Health and Community Medicine/Section of Primary Health Care,
the Sahlgrenska Academy, University of Gothenburg.
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Background
• Depression is one of the major causes of
illness with an estimated prevalence of 10%
and causes lowered functional capacity and
reduced quality of life. Effects of structured
patient centred treatment , and the use of self-
rating scales in primary care is not yet properly
studied.
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Aim
•To study effects of
regular patient centered
consultations with repeated use of self-
rating scales on mild-moderate
depression
in the primary care setting.
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Method• GPs are randomized either to control group (treatment as usual) or
intervention group.
• The study population consists of primary care attendees aged 18 and up with diagnosis of mild to moderate depression (DSM-IV).
• Intervention study population is offered frequent patient centred consultations (regular visits 4 times during 12 weeks) with continuous use of self-rating scale MADRS-S to monitor depression course, in addition to treatment as usual.
• Control study population gets treatment as usual.
• At baseline and after 12 weeks BDI-II and EQ-5D are used to measure depression and QoL in both groups of study population (by a study nurse)
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MADRS-S
MADRS-S
MADRS-S
MADRS-S
GP Randomisation
GP InterventionGP Control
Treatment as usual
Baseline
N= 200
BDI-II, EQ5D
BDI-II, EQ5DGP Control GP Intervention
4 weeks
8 weeks
12 weeks12 weeks12 weeks
Treatment as usual PLUS
Method
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1 2 30
10
20
30
40
50
60
70
BDIEQ-5DGHQ-12
1 2 30
10
20
30
40
50
60
70
BDIEQ-5DGHQ-12
Group 1. Group 2.
Results halfway…
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• If the intervention group shows significantly
better results on reducing depression and
increasing quality of life it can change the way
we approach depression treatment –
• on the other hand, if no differences can be
shown – both managements are good
enough...
Discussion
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Take home message.
• Trials runs smoother with a research nurse (or other profession) on site.(almost 24/7)
• Each site is unique, and requires tailor made solutions in addition to GCP.
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Thank You all for your attention!
