Knappe Susanne, Einsle Franziska, Rummel-Kluge Christine, Heinz Ines, Wieder Gesine, Venz John, Schouler-Ocak Meryam, Wittchen Hans-Ulrich, Lieb Roselind, Hoye Jürgen, Schmitt Jochen, Bergmann Antje, Beesdo-Baum Katja
Institut für Klinische Psychologie und Psychotherapie Chemnitzer Str. 46 01187 Dresden Deutschland Institut für Klinische Psychologie und Psychotherapie, Technische Universität Dresden.
Stiftung Deutsche Depressionshilfe Deutschland Stiftung Deutsche Depressionshilfe.
Z Psychosom Med Psychother. 2018 Sep;64(3):298-311. doi: 10.13109/zptm.2018.64.3.298.
Simple guideline-oriented supportive tools in primary care: Effects on adherence to the S3/NV guideline unipolar depression Objectives: Does the provision of supportive tools improve guideline-oriented recognition and treatment of patients with depression in primary care?
In a nested intervention study, as part of a larger epidemiological study program in German primary care, 46 randomly drawn practices received tools to facilitate identification and treatment decisions.Pre-post effects were compared to 42 matched control practices without intervention.
The proportion of correctly identified depression cases was similar in the intervention (47.2%) and the control group (42.3%, p = 0.537). Compared to controls, practitioners in the intervention group rated their competence in case identification and treatment at post-intervention more positively (p = 0.016). No effects were observed regarding the usage of the tools, practitioners' attitudes towards national depression guidelines, and depression treatment procedures.
Since provision of guideline-oriented tools did not improve recognition and quality of treatment, delineation of alternative strategies for enhanced guideline adherence in primary care for depression is warranted.
基层医疗中简单的以指南为导向的支持工具：对S3/NV单相抑郁症指南依从性的影响
提供支持工具是否能改善基层医疗中抑郁症患者以指南为导向的识别和治疗？
在一项嵌套式干预研究中，作为德国基层医疗一项更大的流行病学研究项目的一部分，46个随机抽取的医疗机构获得了有助于识别和治疗决策的工具。将干预前后的效果与42个未进行干预的匹配对照医疗机构进行比较。
干预组（47.2%）和对照组（42.3%，p = 0.537）中正确识别的抑郁症病例比例相似。与对照组相比，干预组的从业者在干预后对自己在病例识别和治疗方面的能力评价更为积极（p = 0.016）。在工具使用、从业者对国家抑郁症指南的态度以及抑郁症治疗程序方面未观察到影响。
由于提供以指南为导向的工具并未改善识别和治疗质量，因此有必要为提高基层医疗中抑郁症指南的依从性制定替代策略。
