• E H Lin, G E Simon, D J Katzelnick, and S D Pearson.
• Center for Health Studies, Group Health Cooperative of Puget Sound, Seattle, Wash 98101, USA. lin.e@ghc.org
• J Gen Intern Med. 2001 Sep 1; 16 (9): 614619614-9.

ObjectiveTo assess the effect of physician training on management of depression.DesignPrimary care physicians were randomly assigned to a depression management intervention that included an educational program. A before-and-after design evaluated physician practices for patients not enrolled in the intervention trial.SettingOne hundred nine primary care physicians in 2 health maintenance organizations located in the Midwest and Northwest regions of the United States.Patients/ParticipantsComputerized pharmacy and visit data from a group of 124,893 patients who received visits or prescriptions from intervention and usual care physicians.InterventionsPrimary care physicians received education on diagnosis and optimal management of depression over a 3-month training period. Methods of education included small group interactive discussions, expert demonstrations, role-play, and academic detailing of pharmacotherapy, criteria for urgent psychiatric referrals, and case reviews with psychiatric consultants.Measurements And Main ResultsPharmacy and visit data provided indicators of physician management of depression: rate of newly diagnosed depression, new prescription of antidepressant medication, and duration of pharmacotherapy. One year after the training period, intervention and usual care physicians did not differ significantly in the rate of new depression diagnosis (P =.95) or new prescription of antidepressant medicines (P =.10). Meanwhile, patients of intervention physicians did not differ from patients of usual care physicians in adequacy of pharmacotherapy (P =.53) as measured by 12 weeks of continuous antidepressant treatment.ConclusionsAfter education on optimal management of depression, intervention physicians did not differ from their usual care colleagues in depression diagnosis or pharmacotherapy.

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