Evaluating the Impact of an Educational Program on Practice Patterns of Canadian Family Physicians Interested in Depression Treatment.
Primary Care Companion J Clin Psychiatry 2002;4(6):224-231
© Copyright 2017 Physicians Postgraduate Press, Inc.
Background: Depression is frequently
unrecognized and undertreated. Therefore, there is a need to
increase the knowledge and skills of primary care physicians
regarding the diagnosis and treatment of depression. The aim of
this study was to provide, and evaluate the impact of, a brief
educational program with a number of practice tools and resources
in order to improve family physicians' knowledge, diagnosis, and
treatment of depression.
Methods: Two educational programs (general and
enhanced) were delivered to family physicians interested in
depression treatment. The enhanced program focused on more
practical clinical issues such as use of diagnostic and symptom
assessment tools, recommended dosing of citalopram, how to
initiate and discontinue treatment, and relapse prevention.
Physicians' knowledge of depression was assessed pretraining and
posttraining. Chart audits were conducted for 6 months. Primary
endpoints were recognition of depression and pharmacologic
management (initial dose, maximum dose, length of treatment,
adverse events, and concomitant psychotropic drugs). Secondary
endpoints were patient satisfaction with treatment, compliance,
withdrawal from the study, treatment outcome, use of adjunctive
psychotherapy, and number of office visits.
Results: There was a global increase in
physicians' knowledge of depression in the short term. Physicians
in the enhanced group were more likely to use a symptom-based
diagnostic checklist, record the diagnosis of depression, and
prescribe the recommended initial dose of citalopram, and they
referred less frequently for adjunctive psychotherapy. No
difference between educational intervention groups was found in
patient satisfaction, compliance, and treatment outcome.
Conclusions: A well-designed brief, simple, and
low-cost educational program can increase family physicians'
knowledge of depression, improve their diagnostic skills, and
optimize their treatment of depression.