Changes in Diagnostic Patterns of Depression Among Family Physicians in Latvia after Participating in The Education Course on Depression Developed within the National Research Programme Biomedicine 2014–2017: Preliminary Results
Annually, 7.9% of the general population in Latvia are suffering from depression. According to the official statistics, less than 8000 persons a year have been treated for depression in the state-paid health care services while the National Research Programme (NRP) BIOMEDICINE 2014–2017 found that more than 70 000 depressed patients annually are coming to family physicians (FPs) in Latvia. Within NRP researchers have developed an algorithm for diagnostics and treatment of depression and carried out ten educational courses for FPs all over Latvia in 2016. Data on the treatment of depression have been collected from the National Health Service (NHS) database from 01.01.2015 till 30.06.2017. Changes between the trained and control groups have been calculated for the time period before intervention — 2015–2016 and six months right after it. The “Depression School” was attended by 210 (15.2%) out of 1382 FPs, in contract with the NHS, who signed in for the course on first-to-come basis. There were no statistically significant demographic differences between trained and control groups, except, a larger proportion of FPs from rural places vs. the capital city attended the courses. Comparing the trained and control groups, during the period before the intervention there were on average 0.96 vs. 0.83 depressive episodes (F32) and 3.26 vs.1.74 recurrent depressive disorder (F33) episodes in 1/2 year (p < 0.001). Statistically significant increase was observed for F33 episodes (+1.42, p < 0.001), and numeric for F32 episodes (+0.18, p = 0.36) in the trained group of FPs in 2017. In total this gave a statistically significant (p < 0.001) increase by 43.6% of F33 diagnoses following the education course on depression for family physicians. Further analysis of data to access sustainability of training effect after 12 and 24 months are underway.
Benjamin, V., Kohn, R., Levav, I., Espejo, F., Saldivia, S., Sartorius, N. (2007). Training primary care physicians in Chile in the diagnosis and treatment of depression. J. Affect. Disord., 98 (1–2), 121–127.
Bijl, D., van Marwijk, H. W., de Haan, M., van Tilburg, W., Beekman, A. J. (2004). Effectiveness of disease management programmes for recognition, diagnosis and treatment of depression in primary care. Eur. J. Gen. Pract.,10 (1), 6–12.
Ayano, G., D., Haile, K., Chaka, A., Haile, K., Solomon, M., Yohannis, K., Awoke, A., Jemal, K. (2017). Mental health training for primary health care workers and implication for success of integration of mental health into primary care: Evaluation of effect on knowledge, attitude and practices (KAP). Int. J. Mental Health Syst., 11, 63.
Gilbody, S. (2004). What is the evidence on effectiveness of capacity building of primary health care professionals in the detection, management and outcome of depression? WHO Regional Office for Europe, Health Evidence Network report, Copenhagen. Available at: http://www.euro.who.int/Document/E85243.pdf (accessed 26 November 2018).
Leff, M. S., Vrubļevska, J., Lūse, A., Rancāns, E. (2017). Latvian family physicians’ experience diagnosing depression in somatically presenting depression patients: A qualitative study. Eur. J. Gen. Pract.,23 (1), 91–97.
Rancans, E., Trapencieris, M., Ivanovs, R., Vrublevska, J. (2018). Validity of the PHQ-9 and PHQ-2 to screen for depression in nationwide primary care population in Latvia. Ann. Gen. Psychiatry,17, 33.
Sielk, M., Altiner, A., Janssen, B., Becker, N., de Pilars, M. P., Abholz, H. H. (2009). Prevalence and diagnosis of depression in primary care. A critical comparison between PHQ-9 and GPs’ judgement. Psychiatr. Prax.,36 (4), 169–174.
Sikorski, C., Luppa, M., Konig, H. H., van den Bussche, H., Riedel-Heller, S. G. (2012). Does GP training in depression care affect patient outcome? A systematic review and meta-analysis. BMC Health Serv Res,12, 10.
Vrublevska, J., Trapencieris, M., Snikere, S., Grinberga, D., Velika, B., Pudule, I., Rancans, E. (2017). The 12-month prevalence of depression and health care utilization in the general population of Latvia. J. Affect. Disord.,210, 204–210.
Wittchen, H. U., Jacobi, F., Rehm, J., Gustavsson, A., Svensson, M., Jönsson, B., Olesen, J., Allgulander, C., Alonso, J., Faravelli, C., Fratiglioni, L., Jennum, P., Lieb, R., Maercker, A., van Os, J., Preisig, M., Salvador-Carulla, L., Simon, R., Steinhausen, H. C. (2011). The size and burden of mental disorders and other disorders of the brain in Europe 2010. Eur. Neuropsychopharmacol.,21 (9), 655–679.