Depression | Management of Depression in Primary Care
Depression research study
What is the primary objective of this study?
Most people in Sweden with mild to moderate depression are treated in primary care, but follow-up is unstructured, and we know little about whether structured, follow-up would affect the prognosis for depression and working life. The purpose of this study is to determine the effectiveness of regular, structured, patient-centered visits on mild to moderate depression.
Who is eligible to participate?
Inclusion criteria - Age 18 years and up - Attends a participating primary health care center in the region - Diagnosis of mild/moderate depressive disorder (new episode) - No change in possible antidepressant maintenance therapy during the preceding 1 month - Provided written informed consent Exclusion criteria - Antidepressant medication initiated or changed during the preceding 1 month - Patient diagnosed with major depressive disorder (BDI-II >28) - Patients diagnosed of severe mental psychiatric disorder (i.e. bipolar disorder, antisocial personality disorder, psychosis, substance use disorder or other serious mental disorder) - Suicidal ideation or intentions - Inability to speak and understand Swedish language well enough to take part in the activities required in the study. - Cognitive impairment that makes it impossible to take part in the activities required in the study - Does not provide written informed consent to participation in the study
Which medical condition, disease, disorder, syndrome, illness, or injury is researched?
Interventions can include giving participants drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available or noninvasive approaches such as surveys, education, and interviews.
Behavioral:Structured patient-centered follow up of depressionAll patients who agree to participate in the study are diagnosed by their GP with a diagnostic assessment instrument called PRIME-MD. Participants in the intervention group visit their GPs at baseline and 4, 8, and 12 weeks. At each visit, participants complete MADRS-s for the assessment of depression severity and discuss the results with their GP in a patient-centered consultation. We have chosen to use the MADRS/MADRS-S depression rating scale in this study because it is a easy to use standard instrument especially suitable for measuring change in depressive symptoms. The control group receives treatment as usual (no intervention).
Research studies and clinical trials typically have two or more research arms. An arm is a group of people who receive the same treatment in the study.
Structured patient visitsParticipants in the intervention group visit their general practitioner at baseline and 4, 8, and 12 weeks. At each visit, participants complete MADRS-s for the assessment of depression severity and discuss the results with their GP in a patient-centered consultation.
Treatment as usualThe control group receives treatment as usual by general practitioner (no intervention).
Start Date: March 2010
Completed Date: December 2014
Primary Outcome: Change in Depressive symptoms
Secondary Outcome: Change in Quality of life
Study sponsors, principal investigator, and references
Principal Investigator: Cecila Björkelund, Professor
Lead Sponsor: Göteborg University
Collaborator: Vastra Gotaland Region