How well do GPs fulfill their educator role in consultations for depression and anxiety?
OBJECTIVE
To assess general practitioners' (GPs) provision of patient education with respect to patients with depression or anxiety.


METHODS
The study relied on the prospective self-recording of patient consultations by GPs. The participating GPs (n = 78) completed 385 registration forms. For each performance indicator, an indicator score was calculated by dividing the number of clinical situations in which the GPs actually offered patient education by the total number of situations demanding for the provision of such education.


RESULTS
High indicator scores (> 85%) were found for the provision of patient education about the effect and side effects of antidepressant medication in depression care. Moderate indicator scores (60-85%) were found for the provision of patient education about the prevalence and the course of both depression and anxiety. Giving advice to depressed patients to place restrictions upon the amount of demands the patient places on himself showed a substantial gap between recommended and actual care. Furthermore, a low indicator score was also found for patient education about the side effects of antidepressant medication in anxiety care (indicator scores < 60%). The variance across GPs was considerable. The clinical characteristic that had the most robust relationship with a variety of performance indicators was first or follow-up consultation for depression or anxiety.


CONCLUSIONS
GPs' provision of patient education in depression and anxiety care ranged from poor to excellent, depending on the type of educational item.


CONCLUSIONS
Insight into both the actual clinical performance of GPs and determinants of variation in their performance contributes to select the most appropriate means for quality improvement in depression and anxiety care.
Smolders
Mirrian
M
Scientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Centre (RUNMC), Nijmegen, The Netherlands. m.smolders@iq.umcn.nl
Laurant
Miranda
M
Roberge
Pasquale
P
Akkermans
Reinier
R
Wensing
Michel
M
Grol
Richard
R
D000328:Adult; D001007:Anxiety / Q000628:therapy*; D003863:Depression / Q000628:therapy*; D005194:Family Practice; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010353:Patient Education as Topic; D011446:Prospective Studies; D011787:Quality of Health Care