Educational program for general practitioners for the treatment of depression -: evaluation of the IMPROVE-D educational program

Patients with depressive disorders contact their general practitioners first Therefore these physicians have an important role in the management of depression 50 to 70% of patients are diagnosed as having depression by their primary-care physicians. but only a small portion of these patients receive an adequate treatment and follow-up Experts and clinical guidelines suggest drug treatment of six months or more to improve patients midterm outcome However there is overwhelming evidence that individuals with depression are being seriously undertreated. To improve the effectiveness of antidepressant therapy by general practitioners an educational program was developed to optimise the physician-patient-interaction to reach a long-term drug treatment over at least 6 months. Two groups where compared to evaluate the effectiveness of the educational program a control group (receiving no training material) and an education group (receiving training material four times during the study). In both groups patients with depression on Citalopram (Sepram(TM)) medication were observed. Comparing both groups there was no difference in the clinical efficacy of the antidepressant Citalopram, measured with the Hamilton Depression (HAM-D) Scale, the Clinical Global Impression (CGI) Scale und the Short Form-36 Health Survey (SF-36) over the 6 months' period But there was a difference in the quality of treatment Patients in the education group had more physician visits, reached a higher medication compliance, had a longer duration of treatment and showed a lower rate of finishing therapy before the recommended period of at least 6 months (44% control group vs 36% education group) They also felt a bit more satisfied with the quality of medical care they received for depression including drug treatment This improvement in quality of treatment by the depression management program should have positive impact on the risk of relapsing depressed episodes.