title: To score or not to score: a qualitative study on GPs views on the use of instruments for depression.
abstract: BACKGROUND
  To improve the detection, diagnosis and follow-up of depression in primary care patients, it has been proposed that GPs should employ assessment instruments as a complement to the consultation. However, most GPs do not use such instruments routinely.
  
  
  OBJECTIVE
  To explore perceptions of Swedish GPs on the use of instruments in the medical consultation.
  
  
  METHODS
  Twenty-seven GPs discussed in five focus groups that were digitally recorded, transcribed verbatim and analysed by systematic text condensation.
  
  
  RESULTS
  Six code groups emerged from the focus group discussions: (i) a perceived pressure from authorities and psychiatry to report depression scores; (ii) the scores were considered to be of limited value for the GP but could help the patient by facilitating sick leave compensation and hospitalization; (iii) instruments hampered the dialogue with the patient and non-verbal information was lost; (iv) the reliability of questionnaires was questioned; (v) instruments were seen as not fitting into primary care and GPs were uncertain how to use them and (vi) the main advantage of instruments was to promote communication with specific categories of patients.
  
  
  CONCLUSIONS
  Using instruments to obtain a quantitative score of depression was of no benefit to the GPs. Given the weak evidence for the clinical relevance of many instruments, there is little reason to introduce them into practice. However, the instruments can facilitate communication with external actors and specific groups of patients.
authors.affiliation: Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm.
authors.forename: Agneta
authors.initials: A
authors.lastname: Pettersson
authors.forename: Cecilia
authors.initials: C
authors.lastname: Björkelund
authors.forename: Eva-Lisa
authors.initials: EL
authors.lastname: Petersson
mesh_terms: D001291:Attitude of Health Personnel; D003142:Communication; D003866:Depressive Disorder / Q000175:diagnosis*; D005260:Female; D017144:Focus Groups; D058005:General Practitioners; D006801:Humans; D008297:Male; D010817:Physician-Patient Relations; D011594:Psychometrics / Q000295:instrumentation*; D036301:Qualitative Research; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D013548:Sweden
keywords: Depression; focus groups; physicians; primary care; qualitative research; questionnaires.