• Dick Bijl, Harm W J van Marwijk, Marten de Haan, Willem van Tilburg, and Aart-Jan T F Beekman.
• Institute for Research in Extramural Medicine (EMGO Institute), Free University Medical Centre, Amsterdam, the Netherlands. dick.bijl@hetnet.nl
• Eur J Gen Pract. 2004 Mar 1; 10 (1): 6-12.

ObjectivesScreening is advocated to improve the recognition of patients with major depression in primary care. Furthermore, disease management programmes are advocated to improve the quality of care and outcome for these patients. But is screening and the subsequent implementation of a disease management programme more effective than usual care?MethodsReview of the literature on the effects of disease management programmes that include screening for major depression in general practice.ResultsSix randomised controlled trials were identified in which the effectiveness of disease management programmes were studied in patients with major depression in primary care and compared with usual care. The majority of these, and especially the largest, showed positive effects on the recognition, diagnosis, treatment and outcome of patients. Populations in the US seem to benefit most.ConclusionThe results of disease management programmes for major depression in primary care that include screening are positive and are more effective than usual care. Therefore, if proceeded by screening, attention to the whole process of care for patients with major depression instead of paying attention to isolated elements of the process is justified.

17 keywords...

hide…