Mayer Karin, Merlo Christoph, Markun Stefan, Neuner-Jehle Stefan, Beeler Patrick E
Center for Primary and Community Care, Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.
Federal Office of Public Health (FOPH), Swiss Sentinel Surveillance System, Berne, Switzerland.
BMC Prim Care. 2025 Jul 2;26(1):210. doi: 10.1186/s12875-025-02897-9.
To (i) investigate the current state of depression management in Swiss primary care post-COVID-19, focusing on the utilization of guidelines or associated tools, (ii) explore potential associations with depression management, and (iii) evaluate availability of and communication with psychiatrists and psychotherapists.
A previously developed self-report questionnaire, covering screening, diagnosis, management, and interprofessional collaboration, was distributed online, with a supplementary paper version, to 168 Swiss primary care physicians (PCPs) participating in the Swiss Sentinel Surveillance System. Multivariable logistic regressions explored associations.
Of the 168 primary care physicians invited to participate, 116 completed the survey (response rate: 69%). Among these, 61% utilized guidelines for depression management, with statistically significant associations towards increased guideline utilization for PCPs with some psychiatric training as residents (odds ratio [OR] 4.13; 95% confidence interval (95% CI) 1.27, 16.02) and decreased utilization for the age group 60-81 (OR 0.29; 95% CI 0.09, 0.93). Guideline utilization was associated with perceived competency in prescribing antidepressants (OR 3.51; 95% CI 1.21, 11.08). The majority reported difficulties in organizing therapy with mental health specialists and rarely received feedback after patient referrals.
While the utilization of guidelines among participants was inconsistent, over 60% indicated using either guidelines, tools, or both. The study highlights systemic issues in interprofessional collaboration between PCPs and mental health specialists that require attention.
(i) 调查瑞士初级医疗保健机构在新冠疫情后抑郁症管理的现状，重点关注指南或相关工具的使用情况；(ii) 探索与抑郁症管理的潜在关联；(iii) 评估精神科医生和心理治疗师的可及性及沟通情况。
一份先前开发的涵盖筛查、诊断、管理和跨专业协作的自填式问卷通过网络分发，并提供纸质补充版本，发给参与瑞士哨兵监测系统的168名瑞士初级保健医生。多变量逻辑回归分析探索关联。
在受邀参与的168名初级保健医生中，116人完成了调查（回复率：69%）。其中，61%的人使用抑郁症管理指南，接受过住院医师阶段精神科培训的初级保健医生使用指南的比例显著增加（优势比[OR] 4.13；95%置信区间[95% CI] 1.27，16.02），而60 - 81岁年龄组的使用比例降低（OR 0.29；95% CI 0.09，0.93）。指南使用与开具抗抑郁药的感知能力相关（OR 3.51；95% CI 1.21，11.08）。大多数人报告在安排与心理健康专家的治疗方面存在困难，患者转诊后很少收到反馈。
虽然参与者对指南的使用情况不一致，但超过60%的人表示使用了指南、工具或两者都用。该研究突出了初级保健医生与心理健康专家之间跨专业协作中的系统性问题，需要予以关注。
