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Patients' perspectives on the use of the Montgomery-Asberg depression rating scale self-assessment version in primary care.

ABSTRACT: The aim of the current study was to better understand how patients with depression perceive the use of MADRS-S in primary care consultations with GPs.Qualitative study. Focus group discussion and analysis through Systematic Text Condensation.Primary Health Care, Region Västra Götaland, Sweden.Nine patients with mild/moderate depression who participated in a RCT evaluating the effects of regular use of the Montgomery-Åsberg Depression Self-assessment scale (MADRS-S) during the GP consultations.Patients' experiences and perceptions of the use of MADRS-S in primary care.Three categories emerged from the analysis: (I) confirmation; MADRS-S shows that I have depression and how serious it is, (II) centeredness; the most important thing is for the GP to listen to and take me seriously and (III) clarification; MADRS-S helps me understand why I need treatment for depression.Use of MADRS-S was perceived as a confirmation for the patients that they had depression and how serious it was. MADRS-S showed the patients something black on white that describes and confirms the diagnosis. The informants emphasized the importance of patient-centeredness; of being listened to and to be taken seriously during the consultation. Use of self-assessment scales such as MADRS-S could find its place, but needs to adjust to the multifaceted environment that primary care provides. Key Points Patients with depression in primary care perceive that the use of a self-assessment scale in the consultation purposefully can contribute in several ways. The scale contributes to Confirmation: MADRS-S shows that I have depression and how serious it is. Centeredness: The most important thing is for the GP to listen to and take me seriously. Clarification: MADRS-S helps me understand why I need treatment for depression.

SUBMITTER: Wikberg C

PROVIDER: S-EPMC5217279 | biostudies-other | 2016 Dec

REPOSITORIES: biostudies-other

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Patients' perspectives on the use of the Montgomery-Asberg depression rating scale self-assessment version in primary care.

Wikberg Carl C Pettersson Agneta A Westman Jeanette J Björkelund Cecilia C Petersson Eva-Lisa EL

Scandinavian journal of primary health care 20161102 4

<h4>Objective</h4>The aim of the current study was to better understand how patients with depression perceive the use of MADRS-S in primary care consultations with GPs.<h4>Design</h4>Qualitative study. Focus group discussion and analysis through Systematic Text Condensation.<h4>Setting</h4>Primary Health Care, Region Västra Götaland, Sweden.<h4>Subjects</h4>Nine patients with mild/moderate depression who participated in a RCT evaluating the effects of regular use of the Montgomery-Åsberg Depress ...[more]

PMID: 27804312

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Project description:BackgroundLittle information is available about whether the use of self-assessment instruments in primary care affects depression course and outcome. The purpose was to evaluate whether using a depression self-rating scale in recurrent person-centred GP consultations affected depression severity, quality of life, medication use, and sick leave frequency.MethodsPatients in the intervention group met their GP regularly at least 4 times during the 3 months intervention. In addition to treatment as usual (TAU), patients completed a self-assessment instrument (Montgomery-Asberg Depression Rating Scale) on each occasion, and then GPs used the completed instrument as the basis for a person-centred discussion of changes in depression symptoms. The control group received TAU. Frequency of visits in the TAU arm was the result of the GPs' and patients' joint assessments of care need in each case. Depression severity was measured with Beck Depression Inventory-II (BDI-II), quality of life with EQ-5D, and psychological well-being with the General Health Questionnaire-12 (GHQ-12). Data on sick leave, antidepressant and sedatives use, and care contacts were collected from electronic patient records. All variables were measured at baseline and 3, 6, and 12 months. Mean intra-individual changes were compared between the intervention and TAU group.ResultsThere were no significant differences between the intervention and control group in depression severity reduction or remission rate, change in quality of life, psychological well-being, sedative prescriptions, or sick leave during the whole 12-month follow-up. However, significantly more patients in the intervention group continued antidepressants until the 6 month follow-up (86/125 vs 78/133, p < 0.05).ConclusionsWhen GPs used a depression self-rating scale in recurrent consultations, patients more often continued antidepressant medication according to guidelines, compared to TAU patients. However, reduction of depressive symptoms, remission rate, quality of life, psychological well-being, sedative use, sick leave, and health care use 4-12 months was not significantly different from the TAU group. These findings suggest that frequent use of depression rating scales in person-centred primary care consultations has no further additional effect on patients' depression or well-being, sick leave, or health care use.Trial registrationClinicalTrials.gov Identifier: NCT01402206 . Registered June 27 2011(retrospectively registered).

Dataset Information

Patients' perspectives on the use of the Montgomery-Asberg depression rating scale self-assessment version in primary care.

Publications

Patients' perspectives on the use of the Montgomery-Asberg depression rating scale self-assessment version in primary care.

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