Nudging General Practitioners to explore suicidal thoughts among depressed patients

Area of Science:

• Medical Research
• Public Health
• Clinical Psychology

Background:

• Suicide prevention in patients with depression is critical.
• General Practitioners (GPs) often provide suboptimal exploration of suicidal ideation.
• Effective interventions are needed to improve GP practice regarding suicide risk assessment.

Purpose of the Study:

• To evaluate the effectiveness of a pop-up screen intervention designed to prompt GPs to explore suicidal thoughts.
• To assess the impact of this intervention over a two-year period in a Dutch general practice sentinel network.

Main Methods:

• The study involved incorporating a pop-up screen intervention into the information system of a Dutch general practice sentinel network from January 2017 to December 2018.
• The intervention was triggered by new registrations of depression episodes, prompting GPs to complete questionnaires on their behavior regarding suicidal thought exploration.
• Data from 625 completed questionnaires were analyzed using multilevel logistic regression.

Main Results:

• While GPs were 50% more likely to explore suicidal thoughts in the second year compared to the first, this effect diminished after adjusting for patient gender and age.
• Suicide exploration was less frequent in women and older patients.
• Significant variation in suicide exploration existed between general practices, but not over time.

Conclusions:

• The low-cost pop-up screen intervention was not effective in increasing GP's exploration of suicidality.
• Future research should investigate multifaceted approaches to enhance the effectiveness of such interventions.
• Recommendations include incorporating variables like work experience and prior mental health training in future studies to better understand intervention effects on GP behavior.