Effectiveness of disease management programmes for recognition, diagnosis and treatment of depression in primary care.
OBJECTIVE
Screening 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?


METHODS
Review of the literature on the effects of disease management programmes that include screening for major depression in general practice.


RESULTS
Six 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.


CONCLUSIONS
The 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.
Bijl
Dick
D
Institute for Research in Extramural Medicine (EMGO Institute), Free University Medical Centre, Amsterdam, the Netherlands. dick.bijl@hetnet.nl
van Marwijk
Harm W J
HW
de Haan
Marten
M
van Tilburg
Willem
W
Beekman
Aart-Jan T F
AJ
D000293:Adolescent; D000328:Adult; D003863:Depression / Q000175:diagnosis* / Q000628:therapy*; D019468:Disease Management; D006801:Humans; D008875:Middle Aged; D009426:Netherlands; D017063:Outcome Assessment, Health Care; D011320:Primary Health Care / Q000458:organization & administration* / Q000592:standards; D015397:Program Evaluation; D011785:Quality Assurance, Health Care