Adequacy of antidepressant treatment in Spanish primary care: a naturalistic six-month follow-up study.
OBJECTIVE
This study evaluated the adequacy of pharmacological antidepressant treatment in major depressive episodes prescribed in 16 Spanish primary care centers, both during the acute phase of treatment and after the first three months of the continuation phase, under real-world naturalistic conditions (usual care). Factors that could be associated with adequacy of care also were explored.


METHODS
A total of 333 patients from primary care who began pharmacological antidepressant treatment were followed up for six months. Treatment adequacy and associated factors were evaluated.


RESULTS
Between 27% and 32% of patients received adequate antidepressant treatment during the acute phase. Percentages of adequacy were between 21% and 25% when considering the acute phase and the first three months of the continuation phase. Psychiatric consultations were found to be associated with treatment adequacy.


CONCLUSIONS
In state-funded Spanish primary care centers, antidepressant treatment adequacy was poor during both the acute phase and the first three months of the continuation phase. Primary care physicians prescribed suggested antidepressants, mostly as recommended (99%) and at adequate dosages. However, they did not perform the recommended number of follow-up sessions and treated patients with depressive disorders other than major depression as if they had a major depressive episode. Collaborative interventions between primary and specialized care could improve treatment adequacy.
Pinto-Meza
Alejandra
A
Department of Research and Development, Sant Joan de Deu-SSM, Carrer Dr Antoni Pujades, 42 Sant Boi de Llobregat, Barcelona, Spain. apinto@sjd-ssm.com
Fernandez
Anna
A
Serrano-Blanco
Antoni
A
Haro
Josep Maria
JM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004358:Drug Therapy / Q000592:standards*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000592:standards*; D008875:Middle Aged; D011320:Primary Health Care / Q000379:methods*; D012680:Sensitivity and Specificity; D013030:Spain; D011795:Surveys and Questionnaires
D000928:Antidepressive Agents