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Depression treatment in primary care.

W David Robinson1, Jenenne A Geske, Layne A Prest

  • 1Department of Family Medicine, University of Nebraska Medical Center, Omaha, NE 68198-3075, USA. wdrobins@unmc.edu

The Journal of the American Board of Family Practice
|March 31, 2005
PubMed
Summary

Physicians frequently recommend pharmacotherapy for depression, often overlooking evidence-based guidelines. Combination therapy is more common among family medicine practitioners and female physicians, highlighting potential disparities in depression treatment.

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Area of Science:

  • Medical research
  • Clinical practice
  • Mental health

Background:

  • Depression incurs significant annual costs in the United States.
  • Primary care physicians are crucial for identifying and managing depression.
  • This study examines physician treatment recommendations against established guidelines.

Purpose of the Study:

  • To assess physician adherence to recommended depression treatment guidelines.
  • To identify patterns in treatment selection for newly diagnosed depression.
  • To explore factors influencing treatment choices in primary care.

Main Methods:

  • Retrospective chart review of treatment recommendations for newly diagnosed depression patients.
  • Inclusion of patients from family medicine and general internal medicine practices.

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  • Data collected from a Midwest university medical center setting.

    • Main Results:

    • Pharmacotherapy was the most common intervention (52%), while psychotherapy alone was least common (4%).
    • Family medicine practitioners favored combination therapy over general internal medicine practitioners (P=.022).
    • Female physicians were more likely to recommend combination therapy than male physicians (P=.010).

    Conclusions:

    • Physician treatment choices, particularly the high use of pharmacotherapy, deviate from evidence-based recommendations.
    • Barriers to effective depression treatment plans are discussed.
    • Implications for mental health interventions, combination therapy, and cost-effectiveness are explored, with a call for further research into patient-provider negotiation dynamics.