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Effects on depression pharmacotherapy of a Dutch general practitioner training program
T W D P van Os1, R H S van den Brink, J A Jenner
1Department of Psychiatry and Graduate School of Behavioural and Cognitive Neurosciences, University of Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands. t.w.d.p.van.os@med.rug.nl
Background:
General practitioners' (GPs) ability to recognize, diagnose and treat depression improved significantly after a comprehensive, 20-h training programme. This study aims to evaluate in more detail the effects of the training on GPs' pharmacotherapy of depression and related issues.
Methods:
A pretest-posttest design was used. Both in the pre- and post-training phase, a sample was drawn from consecutive patients of the 17 participating GPs. In the pre-training phase we identified a sample of 31 cases with an ICD-10 depression who received an antidepressant from their GP. The sample was followed for 1 year. Outcome measures were: type of antidepressant, dosage, duration and number of target instructions given by the GP. Then we trained the GPs. In the post-training phase, we identified a new sample (n = 47) from their practices and measured the same outcomes.
Results:
Improvements were seen in choice for modern antidepressant, adequate dosage, adequate duration, and number of target instructions given.
Limitations:
Observed changes can be due to a period effect, inherent in a pre-post design.
Conclusions:
A post-academic hands-on training of GPs can improve depression pharmacotherapy according to clinical guidelines with respect to choice of a modern antidepressant, adequate dosage, adequate duration and psychoeducation.
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