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Depression case management by practice nurses in primary care: an audit.
1Nurse Consultant Primary Care Mental Health, Tees Esk and Wear Valleys NHS Trust, and Honorary Clinical Lecturer, Mental Health Research Centre, Durham University, UK.
Mental Health in Family Medicine
|April 6, 2012
Summary
Practice nurses can effectively manage depression in primary care. An audit showed significant symptom improvement and high patient satisfaction, offering a viable, cost-effective model for enhanced depression care.
Area of Science:
- Primary Care Medicine
- Mental Health Services
- Nursing Practice
Background:
- Depression is a prevalent and disabling condition impacting primary care.
- Collaborative care models show promise for improving depression outcomes but are underutilized in general practice.
- There is a need to integrate effective depression management strategies into routine primary care settings.
Purpose of the Study:
- To audit an enhanced care initiative training practice nurses in collaborative depression care.
- To evaluate symptom outcomes and patient satisfaction with this intervention.
- To benchmark results against randomized trial data and estimate costs.
Main Methods:
- An audit of depression case-management clinics run by practice nurses.
- Measurement of symptom outcomes using the Patient Health Questionnaire (PHQ-9).
- Patient satisfaction surveys and cost estimation of practice nurse time.
Main Results:
- A significant mean reduction of 9.07 points on the PHQ-9 score was observed (P < 0.001).
- Clinical improvement shifted patients from moderate-to-severe to mild depression.
- Patients reported high satisfaction, and the mean cost was estimated at £45 per patient.
Conclusions:
- Practice nurses can provide effective and acceptable case management for depression in general practice.
- The initiative demonstrated outcomes comparable to or better than randomized controlled trials.
- This model offers a potentially cost-effective approach to enhancing depression care within primary care settings.
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