Thompson C, Kinmonth AL, Stevens L, Peveler RG, Stevens A, Ostler KJ, et al. Effects of a clinical practice guideline and practice-based education on detection and outcome of depression in primary care: Hampshire depression project randomised controlled trial. Lancet 2000;355:185.
Also, a BMJ editorial - Kendrick T. Why can't GPs follow guidelines on depression? BMJ 2000;320:200.
A study carried out in Hampshire, concluded that teaching the diagnosis and management of depression did not result in improved recognition or patient outcome. The BMJ editorial examines why this may be the case, and concludes that depression guidelines are often unhelpful. This is because diagnosis in primary care and deciding on the appropriate level of depression to initiate therapy is difficult to make. Secondly there is doubt among GPs as to whether antidepressants are effective where patients face major social problems. And thirdly patients themselves can be reluctant to take drugs which they may still perceive to be habit forming, and many discontinue treatment after a few weeks. Another role for the pharmacist?
What's in the medical press? - The rapidly changing situation in primary care means that it is often difficult to keep up to date with what is happening politically and clinically. This section of Primary Care Pharmacy will try to pick out a few articles that may be useful in day-to-day practice or have importance for the primary care role.