Treatment of depression in primary care

doi:10.1136/bmj.b934

Published 19 March 2009, doi:10.1136/bmj.b934
Cite this as: BMJ 2009;338:b934

Editorials

Treatment of depression in primary care

Incentivised care is no substitute for professional judgment

The first 150 words of the full text of this article appear below.

Patients with chronic depression commonly present to generalpractice,¹ and they often have other important (physical) diseases.²Although effective treatment is available, evidence suggeststhat patients and practitioners make insufficient use of it.³These are important reasons to improve general practitioners’care of depression, as pursued by the World Health Organizationaction to integrate mental health into primary care.⁴ In Englandand Scotland, the quality and outcomes framework (QOF) identifiesevidence based interventions and provides financial incentivesto practices that implement these interventions. This excitingand innovative approach to improving performance is followedwith interest outside the United Kingdom.

Two linked studies look at the QOF system and the managementof depression in primary care. Kendrick and colleagues (doi:10.1136/bmj.b750)assess whether rates of prescribing antidepressant drugs andreferrals to specialist services vary according to patients’scores on incentivised depression questionnaires.⁵ Validatedscreening instruments to assess the severity of . . . [Full text of this article]

Chris van Weel, professor of general practice, Evelyn van Weel-Baumgarten, associate professor of medical communications skills, Eric van Rijswijk, general practitioner

¹ Department of Primary and Community Care, Radboud University Nijmegen Medical Centre, 6500 HB Nijmegen, Netherlands

C.vanweel@hag.umcn.nl

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