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Depression case management by practice nurses in primary care: an audit

Ekers, D.; Wilson, W.

Authors

D. Ekers

W. Wilson



Abstract

Introduction: Depression is a common and debilitating condition. A body of evidence exists about improving depression outcomes in primary care, using collaborative care models. Such approaches, however, have not been routinely adopted within general practice settings. In this paper we outline the results of an audit of an enhanced care initiative that trained practice nurses to deliver such approaches. Method: An audit of symptom outcome and satisfaction was conducted in depression case-management clinics run by practice nurses. Results were then benchmarked against appropriate randomised trial data. The cost of practice nurse time devoted to the delivery of the service was estimated by multiplying time by unit cost. Results: A mean change of 9.07 (standard deviation (SD) 6.67, 95% confidence interval (CI) 7.93-10.22, P<0.001) points on the Patient Health Questionnaire (PHQ9) score was observed in those who were using/had used the service. Clinical change demonstrated a shift from moderate-to-severe to mild depression. The results reflect the changes seen in randomised controlled trial data from similar interventions in similar samples, and are superior to expected treatment as usual outcomes. Overall, respondents were 'very satisfied' with the service on offer. The mean cost of practice nurse time was estimated at £45 per patient. Discussion: While acknowledging the limitations of audit data, practice nurses in general practice appear to be able to offer effective and acceptable case management to patients experiencing depression.

Citation

Ekers, D., & Wilson, W. (2008). Depression case management by practice nurses in primary care: an audit. Mental health in family medicine, 5(2), 111-119

Journal Article Type Article
Publication Date Jun 1, 2008
Deposit Date May 13, 2011
Journal Mental health in family medicine
Print ISSN 1756-834X
Electronic ISSN 1756-8358
Publisher Radcliffe Publishing
Peer Reviewed Peer Reviewed
Volume 5
Issue 2
Pages 111-119
Keywords Depression, Depression case management, Practice nurses, Primary care.
Publisher URL http://www.ingentaconnect.com/content/rmp/mhfm/2008/00000005/00000002/art00008