Eficàcia d'un programa multicomponent per a l'abordatge de la depressió en atenció primària

Identificador:  TDX:1127

Handle:  https://hdl.handle.net/20.500.11797/TDX1127

Autors:  Caballero Alías, Antonia

Resum:
Objective: To assess the effectiveness of a multi-component programme to improve the management of depression in primary care. Methods: Cluster-randomized controlled trial. Twenty primary care centres allocated to intervention group (IG) or control group (CG). Intervention: multi-component programme with clinical, educational and organizacional procedures including primary care nurses working as care-managers. Outcomes were monitored by a blinded interviewer at 0, 3, 6 and 12 months. Results: 338 adult patients with major depression (DSM-IV). At 12 months, 302 patients were assessed (IG: 172, CG: 130). The severity of depression (PHQ-9) was 1.76 points lower in the IG [7.15 vs. 8.78, 95% CI=-3.53 to 0.02, p=0.053]. The treatment response rate was 15.4% higher in the IG [66.9% vs. 51.5%, OR 1.9, 95% CI=1.2 to 3.1, p=0.011)], and the remission rate was 13.4% higher [48.8% vs. 35.4%, OR 1.8, 95% CI=1.1 to 2.9, p=0.026)]. Conclusions: The programme for managing depression leads to better clinical outcomes in patients with major depression in primary care settings.