Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2009 Feb;59(559):e32-7.
doi: 10.3399/bjgp09X395085.

Recorded quality of care for depression in general practice: an observational study

Sivatharan Vedavanam  1 , Nicholas Steel, Joanne Broadbent, Susan Maisey, Amanda Howe
Affiliations
Multicenter Study

Recorded quality of care for depression in general practice: an observational study

Sivatharan Vedavanam et al. Br J Gen Pract. 2009 Feb.

Abstract

Background: Depression is a leading cause of disease and disability internationally, and is responsible for many primary care consultations. Little is known about the quality of primary care for depression in the UK.

Aim: To determine the prevalence of good-quality primary care for depression, and to analyse variations in quality by patient and practice characteristics.

Design of study: Retrospective observational study.

Setting: Eighteen general practices in England.

Method: Medical records were examined for 279 patients. The percentage of eligible participants diagnosed with depression who received the care specified by each of six quality indicators in 2002 and 2004 was assessed. Associations between quality achievement and age, sex, patient deprivation score, timepoint, and practice size were estimated using logistic regression.

Results: There was very wide variation in achievement of different indicators (range 1-97%). Achievement was higher for indicators referring to treatment and follow-up than for indicators referring to history taking. Achievement of quality indicators was low overall (37%). Quality did not vary significantly by patient or practice characteristics.

Conclusion: There is substantial scope for improvement in the quality of primary care for depression, if the highest achievement rates could be matched for all indicators. Given the lack of variation by practice characteristics, system-level and educational interventions may be the best ways to improve quality. The equitable distribution of quality by patient deprivation score is an important achievement that may be challenging to maintain as quality improves.

PubMed Disclaimer

Comment in

References

    1. National Institute for Health and Clinical Excellence. Scope. Depression: management of depression in adults in primary and secondary care (update) http://www.nice.org.uk/nicemedia/pdf/DPSC_Scope_for_Consultation_240807.pdf (accessed 19 Sept 2008)
    1. Scottish Executive. Social focus on men and women 2002, Scottish Executive National Statistics. http://www.scotland.gov.uk/stats/sfwm/docs/sfwm-06.asp (accessed 17 Dec 2008)
    1. Scott J, Thorne A, Horn P. Effect of a multifaceted approach to detecting and managing depression in primary care. BMJ. 2002;325(7370):951–954. - PMC - PubMed
    1. Thomas CM, Morris S. Cost of depression among adults in England in 2000. Br J Psychiatry. 2003;183:514–519. - PubMed
    1. Hippisley-Cox J, Fielding K, Pringle M. Depression as a risk factor for ischaemic heart disease in men: population based case-control study. BMJ. 1998;316(7146):1714–1719. - PMC - PubMed

Publication types