Publication

Implementing guidelines for depression on antidepressant prescribing in general practice: a quasi-experimental evaluation

Franx, G., Huyser, J., Koetsenruijter, J., van der Feltz-Cornelis, C. M., Verhaak, P. F. M., Grol, R. P. T. M. & Wensing, M., 19-Feb-2014, In : BMC Family Practice. 15, 7 p., 35.

Research output: Contribution to journalArticleAcademicpeer-review

APA

Franx, G., Huyser, J., Koetsenruijter, J., van der Feltz-Cornelis, C. M., Verhaak, P. F. M., Grol, R. P. T. M., & Wensing, M. (2014). Implementing guidelines for depression on antidepressant prescribing in general practice: a quasi-experimental evaluation. BMC Family Practice, 15, [35]. https://doi.org/10.1186/1471-2296-15-35

Author

Franx, Gerdien ; Huyser, Jochanan ; Koetsenruijter, Jan ; van der Feltz-Cornelis, Christina M. ; Verhaak, Peter F. M. ; Grol, Richard P. T. M. ; Wensing, Michel. / Implementing guidelines for depression on antidepressant prescribing in general practice : a quasi-experimental evaluation. In: BMC Family Practice. 2014 ; Vol. 15.

Harvard

Franx, G, Huyser, J, Koetsenruijter, J, van der Feltz-Cornelis, CM, Verhaak, PFM, Grol, RPTM & Wensing, M 2014, 'Implementing guidelines for depression on antidepressant prescribing in general practice: a quasi-experimental evaluation', BMC Family Practice, vol. 15, 35. https://doi.org/10.1186/1471-2296-15-35

Standard

Implementing guidelines for depression on antidepressant prescribing in general practice : a quasi-experimental evaluation. / Franx, Gerdien; Huyser, Jochanan; Koetsenruijter, Jan; van der Feltz-Cornelis, Christina M.; Verhaak, Peter F. M.; Grol, Richard P. T. M.; Wensing, Michel.

In: BMC Family Practice, Vol. 15, 35, 19.02.2014.

Research output: Contribution to journalArticleAcademicpeer-review

Vancouver

Franx G, Huyser J, Koetsenruijter J, van der Feltz-Cornelis CM, Verhaak PFM, Grol RPTM et al. Implementing guidelines for depression on antidepressant prescribing in general practice: a quasi-experimental evaluation. BMC Family Practice. 2014 Feb 19;15. 35. https://doi.org/10.1186/1471-2296-15-35


BibTeX

@article{99a95a21862f4616b284cb54fbcb117b,
title = "Implementing guidelines for depression on antidepressant prescribing in general practice: a quasi-experimental evaluation",
abstract = "Background: Internationally, guidelines for depression recommend a stepped care approach, implying that antidepressant medication should not be offered as a first step treatment to patients with sub-threshold or mild depression. In the Netherlands, antidepressant prescribing rates in general practice as a first treatment step are considered to be high. The aim of this study was to evaluate the implementation of guideline recommendations on antidepressant prescribing.Methods: A quasi-experimental study with a non-equivalent naturalistic control group and three years follow-up was performed in the general practice setting in the Netherlands. General Practitioners (GPs) participated in a national Quality Improvement Collaborative (QIC), focusing on the implementation of a guideline based model for a stepped care approach to depression. The model consisted of self-help and psychological treatment options for patients with milder symptoms as an alternative to antidepressants in general practice. Changes in antidepressant prescription rates of GPs were documented for a three-year period and compared to those in a control group of GPs, selected from an ongoing national registration network.Results: A decrease of 23.3{\%} (49.4{\%}-26.1{\%}) in antidepressant prescription rates for newly diagnosed patients with depressive symptoms was found within the intervention group, whereas no difference occurred in the reference group (50.3{\%}-52.6{\%}). The decrease over time was significant, compared to the usual care group (OR 0.44, 95{\%} CI: 0.21-0.92).Conclusions: An implementation program using stepped care principles for the allocation of depression interventions resulted in reduced antidepressant prescription rates in general practice. GPs can change prescribing behaviour within the context of a QIC.",
keywords = "General practice, Guidelines, Antidepressants, Implementation, Stepped care, QUALITY IMPROVEMENT, PRIMARY-CARE, ANXIETY DISORDERS, STEPPED-CARE, COLLABORATIVES, HEALTH, TRENDS, NICE",
author = "Gerdien Franx and Jochanan Huyser and Jan Koetsenruijter and {van der Feltz-Cornelis}, {Christina M.} and Verhaak, {Peter F. M.} and Grol, {Richard P. T. M.} and Michel Wensing",
year = "2014",
month = "2",
day = "19",
doi = "10.1186/1471-2296-15-35",
language = "English",
volume = "15",
journal = "BMC Family Practice",
issn = "1471-2296",
publisher = "BioMed Central Ltd.",

}

RIS

TY - JOUR

T1 - Implementing guidelines for depression on antidepressant prescribing in general practice

T2 - a quasi-experimental evaluation

AU - Franx, Gerdien

AU - Huyser, Jochanan

AU - Koetsenruijter, Jan

AU - van der Feltz-Cornelis, Christina M.

AU - Verhaak, Peter F. M.

AU - Grol, Richard P. T. M.

AU - Wensing, Michel

PY - 2014/2/19

Y1 - 2014/2/19

N2 - Background: Internationally, guidelines for depression recommend a stepped care approach, implying that antidepressant medication should not be offered as a first step treatment to patients with sub-threshold or mild depression. In the Netherlands, antidepressant prescribing rates in general practice as a first treatment step are considered to be high. The aim of this study was to evaluate the implementation of guideline recommendations on antidepressant prescribing.Methods: A quasi-experimental study with a non-equivalent naturalistic control group and three years follow-up was performed in the general practice setting in the Netherlands. General Practitioners (GPs) participated in a national Quality Improvement Collaborative (QIC), focusing on the implementation of a guideline based model for a stepped care approach to depression. The model consisted of self-help and psychological treatment options for patients with milder symptoms as an alternative to antidepressants in general practice. Changes in antidepressant prescription rates of GPs were documented for a three-year period and compared to those in a control group of GPs, selected from an ongoing national registration network.Results: A decrease of 23.3% (49.4%-26.1%) in antidepressant prescription rates for newly diagnosed patients with depressive symptoms was found within the intervention group, whereas no difference occurred in the reference group (50.3%-52.6%). The decrease over time was significant, compared to the usual care group (OR 0.44, 95% CI: 0.21-0.92).Conclusions: An implementation program using stepped care principles for the allocation of depression interventions resulted in reduced antidepressant prescription rates in general practice. GPs can change prescribing behaviour within the context of a QIC.

AB - Background: Internationally, guidelines for depression recommend a stepped care approach, implying that antidepressant medication should not be offered as a first step treatment to patients with sub-threshold or mild depression. In the Netherlands, antidepressant prescribing rates in general practice as a first treatment step are considered to be high. The aim of this study was to evaluate the implementation of guideline recommendations on antidepressant prescribing.Methods: A quasi-experimental study with a non-equivalent naturalistic control group and three years follow-up was performed in the general practice setting in the Netherlands. General Practitioners (GPs) participated in a national Quality Improvement Collaborative (QIC), focusing on the implementation of a guideline based model for a stepped care approach to depression. The model consisted of self-help and psychological treatment options for patients with milder symptoms as an alternative to antidepressants in general practice. Changes in antidepressant prescription rates of GPs were documented for a three-year period and compared to those in a control group of GPs, selected from an ongoing national registration network.Results: A decrease of 23.3% (49.4%-26.1%) in antidepressant prescription rates for newly diagnosed patients with depressive symptoms was found within the intervention group, whereas no difference occurred in the reference group (50.3%-52.6%). The decrease over time was significant, compared to the usual care group (OR 0.44, 95% CI: 0.21-0.92).Conclusions: An implementation program using stepped care principles for the allocation of depression interventions resulted in reduced antidepressant prescription rates in general practice. GPs can change prescribing behaviour within the context of a QIC.

KW - General practice

KW - Guidelines

KW - Antidepressants

KW - Implementation

KW - Stepped care

KW - QUALITY IMPROVEMENT

KW - PRIMARY-CARE

KW - ANXIETY DISORDERS

KW - STEPPED-CARE

KW - COLLABORATIVES

KW - HEALTH

KW - TRENDS

KW - NICE

U2 - 10.1186/1471-2296-15-35

DO - 10.1186/1471-2296-15-35

M3 - Article

VL - 15

JO - BMC Family Practice

JF - BMC Family Practice

SN - 1471-2296

M1 - 35

ER -

ID: 16358194