Primary care perspectives on generalized anxiety disorder

Area of Science:

• Psychiatry
• Primary Care Medicine
• Public Health

Background:

• Generalized anxiety disorder (GAD) is prevalent, affecting 5.8% of the population, yet receives less attention than other anxiety disorders.
• A significant portion of primary care patients with somatic complaints have undiagnosed mood or anxiety disorders.
• GAD is associated with increased healthcare utilization and costs, including emergency department visits and pharmacy expenses.

Purpose of the Study:

• To highlight the underdiagnosis and undertreatment of GAD in primary care settings.
• To discuss the barriers to effective GAD treatment within the primary care environment.
• To introduce the collaborative care model as a potential solution for improving GAD management.

Main Methods:

• Review of existing literature on GAD prevalence, diagnosis, and treatment in primary care.
• Analysis of barriers to care, including provider knowledge, patient engagement, and system limitations.
• Description of the collaborative care model and its components for managing GAD.

Main Results:

• Primary care recognition of pure anxiety cases is low (23%) compared to depression (56%).
• Barriers to GAD treatment include time constraints, system focus on acute care, lack of follow-up, and limited specialist access.
• The collaborative care approach involves patient education, physician support by extenders, and systematic patient follow-up.

Conclusions:

• Improving GAD treatment in primary care requires enhanced provider knowledge and increased patient engagement.
• The collaborative care model offers a structured approach to overcome existing barriers in managing GAD.
• Effective primary care management of GAD is crucial due to its prevalence and impact on healthcare utilization.