Adherence to evidence-based guidelines for depression and anxiety disorders is associated with recording of the diagnosis.
OBJECTIVE
To assess professionals' adherence to evidence-based guidelines and to investigate whether or not this is influenced by recording of the diagnosis and symptom severity.


METHODS
Analysis of baseline cross-sectional data of a cohort study of 721 primary care patients with a confirmed diagnosis of a depressive or anxiety disorder. Information on the management of depressive and anxiety disorders was gathered from the electronic medical patient records. Guideline adherence was measured by an algorithm, based on performance indicators.


RESULTS
Forty-two percent of the patients with a depressive disorder was treated in accordance with the guideline, whereas 27% of the patients with an anxiety disorder received guideline-consistent care. The provision of care in line with current depression and anxiety guidelines was around 50% for persons with both types of disorders. Documentation of an International Classification of Primary Care diagnosis of depression or anxiety disorder appeared to have a strong influence on guideline adherence. Symptom severity, however, did not influence guideline adherence.


CONCLUSIONS
Adherence to depression and anxiety guidelines can be improved, even when the general practitioner makes the diagnosis and records it. Data on actual health care delivery and quality of care provide insight and may be useful in developing quality improvement activities.
Smolders
Mirrian
M
Scientific Institute for Quality of Health Care, Radboud University Nijmegen Medical Centre (RUNMC), Nijmegen, The Netherlands. m.smolders@iq.umcn.nl
Laurant
Miranda
M
Verhaak
Peter
P
Prins
Marijn
M
van Marwijk
Harm
H
Penninx
Brenda
B
Wensing
Michel
M
Grol
Richard
R
D000328:Adult; D001008:Anxiety Disorders / Q000175:diagnosis*; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis*; D004282:Documentation; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D011320:Primary Health Care; D011787:Quality of Health Care