title: Healthcare team training programs aimed at improving depression management in primary care: A systematic review.
abstract: Although evidence from Latin America and the Caribbean suggests that depression can be effectively treated in primary care settings, depression management remains unevenly performed. This systematic review evaluates all the international evidence on healthcare team training programs aimed at improving the outcomes of patients with depression.
  
  
  
  Three databases were searched for articles in English or Spanish indexed up to November 20, 2014. Studies were included if they fulfilled the following conditions: clinical trials, meta-analyses, or systematic reviews; and if they evaluated a training or educational program intended to improve the management of depression by primary healthcare teams, and assessed change in depressive symptoms, diagnosis or response rates, referral rates, patients' satisfaction and/or quality of life, and the effectiveness of treatments.
  
  
  
  Nine studies were included in this systematic review. Five trials tested the effectiveness of multi-component interventions (training included), and the remaining studies evaluated the effectiveness of specific training programs for depression management. All the studies that implemented multi-component interventions were efficacious, and half of the training trials were shown to be effective.
  
  
  
  Contribution of training programs alone to the effectiveness of multi-component interventions is yet to be established. The lack of specificity regarding health providers' characteristics might be a confounding factor.
  
  
  
  The review conducted suggests that stand-alone training programs are less effective than multi-component interventions. In applying the evidence gathered from developed countries to Latin America and the Caribbean, these training programs must consider and address local conditions of mental health systems, and therefore multi-component interventions may be warranted.
authors.affiliation: Department of Psychiatry and Mental Health, Clinical Hospital, Universidad de Chile, Santiago, Chile; Millennium Institute for Depression and Personality Research (MIDAP), Santiago, Chile; Mood Disorders Program, Tufts Medical Center, Tufts University, Boston, USA.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Vöhringer
authors.affiliation: Clinical Hospital, Universidad de Chile, Santiago, Chile.
authors.forename: Ariel
authors.initials: A
authors.lastname: Castro
authors.affiliation: Department of Psychiatry and Mental Health, Clinical Hospital, Universidad de Chile, Santiago, Chile; Millennium Institute for Depression and Personality Research (MIDAP), Santiago, Chile; School of Psychology, Faculty of Humanities, Universidad de Santiago de Chile, Santiago, Chile. Electronic address: pablo88.martinezdiaz@gmail.com.
authors.forename: Pablo
authors.initials: P
authors.lastname: Martínez
authors.affiliation: Department of Psychiatry and Mental Health, Clinical Hospital, Universidad de Chile, Santiago, Chile.
authors.forename: Álvaro
authors.initials: Á
authors.lastname: Tala
authors.affiliation: School of Medicine, Faculty of Medicine, Universidad de Chile, Santiago, Chile.
authors.forename: Simón
authors.initials: S
authors.lastname: Medina
authors.affiliation: Department of Psychiatry and Mental Health, Clinical Hospital, Universidad de Chile, Santiago, Chile; Millennium Institute for Depression and Personality Research (MIDAP), Santiago, Chile.
authors.forename: Graciela
authors.initials: G
authors.lastname: Rojas
mesh_terms: D003866:Depressive Disorder / Q000628:therapy*; D019468:Disease Management; D004502:Education, Medical, Continuing / Q000379:methods*; D006801:Humans; D007318:Inservice Training / Q000458:organization & administration*; D008605:Mental Health Services; D010348:Patient Care Team; D017060:Patient Satisfaction; D011320:Primary Health Care; D011788:Quality of Life
keywords: Depressive disorder; Education; Primary health care; Systematic review