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Results of the Implementation of a Spanish Computerized Guideline for Depression in Primary Care

Published online by Cambridge University Press:  23 March 2020

D. Palao Vidal ,
M. Cavero ,
J.A. Monreal ,
J.M. Bonet ,
M.D. Moreno  and
V. Peréz -Solà
D. Palao Vidal
Affiliation:
Parc Tauli Sabadell hospital universitari, mental health, Sabadell, Spain
M. Cavero
Affiliation:
Institute of neurociencies. hospital clinic., community mental health center, Barcelona, Spain
J.A. Monreal
Affiliation:
Parc Tauli- university hospital, mental health, Sabadell, Spain
J.M. Bonet
Affiliation:
Institut Català de la Salut, SAP, Barcelona, Spain
M.D. Moreno
Affiliation:
Institut Català de la Salut, SAP Cerdanyola i Sabadell, Sabadell, Spain
V. Peréz -Solà
Affiliation:
Institut of neuropsychiatry and addictions- Parc de Salut Mar, mental health, Barcelona, Spain

Abstract

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A new computerized CPG for Major Depression (e-CPG-MD) was integrated in electronic medical records of primary care in a 7 million population in Catalonia (Spain). An integrated design allows precise access in each patient visit, improving diagnosis, treatment and follow-up. It facilitates an evaluation of suicide risk in depressed patients.

Objective

To evaluate the effects of a multifactor process of implementation of the e-CPG MD, analyzing its use and the key clinical outcomes.

Methods

A cluster randomized clinical trial was performed in 10 primary care centers (PCC) in Barcelona. In five of ten centers a multifaceted implementation process of the e-CPG-MD was developed during 6 month. The others five PCCs received only an usual diffusion. The multifaceted process includes an establishment of local implementation teams, an interactive training program, regular feedback audits, educational outreach visits and periodic reminders.

Results

At six month, a greater proportion of new MD patients from active PCCs were included in the e- CPG-DEP (4.1% + 3.1% vs. 52.7% + 7.3%, p < 0.001); the incidence of MD diagnostics of Major Depression increased significantly (rate quotient = 1.56, p < 0.001) and the proportion of cases with moderate and severe MD too (13.6% vs 41.1%, p = 0.002).

Conclusions

A multifaceted implementation method of an e-CPG-MD increased significantly its uses, the registered incidence of MD and improved the capacity of recognizing severity. Further analysis is necessary in order to determine the impact on clinical outcomes.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Type
Symposium: New IT (information technology) applications in mental health: how we can improve outcomes?
Information
European Psychiatry , Volume 41 , Issue S1: Abstract of the 25th European Congress of Psychiatry , April 2017 , pp. S22
Copyright
Copyright © European Psychiatric Association 2017
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