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Elmārs Rancāns and Anda Ķīvīte-Urtāne

Abstract

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.

Open access

Vineta Viktorija Vinogradova, Jeļena Vrubļevska and Elmārs Rancāns

Abstract

Depression is among the most common mental disorders in primary care. Despite high prevalence rates it remains to be under-diagnosed in primary care settings over the world. This study was aimed to identify Latvian family physicians’ (FPs) experience and attitude in diagnosing and managing depression. It was carried out within the framework of the National Research Programme BIOMEDICINE 2014–2017. After educational seminars on diagnosing and managing depression, FPs were asked to complete a structured questionnaire. In total 216 respondents were recruited. Most of the doctors, or 72.2% (n = 156), agreed with the statement that patients with depression use primary care facilities more often than other patients. More than a half of physicians, or 66.3% (n = 143) quite often asked their patients about their psycho-emotional status and 65.7% (n = 142) of clinicians thought that they can successfully assess a patient’s psychoemotional status and possible mental disorders. The majority, or 91.6 % (n = 198), supposed that routine screening for depression is necessary in Latvia. Despite the fact that a significant number, or 62.6% (n = 135) of FPs thought that their practice was well suitable for the treatment of depressive patients, half of the respondents, or 50.9% (n = 110), assessed their ability to build a trustful contact and to motivate patients for treatment as moderate. Although FPs acknowledged the importance and necessity to treat depression, current knowledge and management approaches were far from optimal. This justifies the need to provide specific training programmes for FPs.