Current Issues in Pharmacoeconomics 2 ________________________________________________ __ Primary-care treabnent of major depression - an update Both antidepressant pharmacotherapy and psychotherapy remain effective in the treatment of patients with major depression when transferred from psychiatric to primary-care settings. This is one of the main findings of a review of randomised controlled trials in primary-care settings published between 1992 and 1998, conducted by US-based researchers. Most patients with major depression can be treated successfully in primary care, say the researchers. They also suggest that it is 'logical' to allow patient preference to influence the choice of treatment. However, properly organised treatment programmes are important to improve clinical practice. Furthermore, there is a prominent role for the specialist physician as consultant, educator and primary provider for the more severely ill. Guideline implementation needs research The researchers conducted the review with reference to the 1993 AHCPR* guidelines for the primary-care treatment of major depression, noting that the guideline's 'potential to improve patient outcomes and reduce practice variation was not totally fulfilled'. The method of implementing these guidelines in routine practice remains one of the subjects of future research in this field, they note. * US Agency for Health Care Policy and Research Schulberg He. Katon W. Simon GE. Rush AJ. Treating major depression in primary care practice: an update of the Agency for Health Care Policy and Research Practice Guidelines. Archives of General Psychiatry 55: 1121-1127. Dec 1998 800730>04 PharmacoEconomics & CIuIcomes News 30 Jan 1I11III No. 197 1173-5503I99/0197-OOO2I$01.orf> Adlalnt8matlonal Um1t8cl1111111. All rlghta

Primary-care treatment of major depression - an update

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Current Issues in Pharmacoeconomics 2 ________________________________________________ __

Primary-care treabnent of major depression - an update

Both antidepressant pharmacotherapy and psychotherapy remain effective in the treatment of patients with major depression when transferred from psychiatric to primary-care settings. This is one of the main findings of a review of randomised controlled trials in primary-care settings published between 1992 and 1998, conducted by US-based researchers.

Most patients with major depression can be treated successfully in primary care, say the researchers. They also suggest that it is 'logical' to allow patient preference to influence the choice of treatment. However, properly organised treatment programmes are important to improve clinical practice. Furthermore, there is a prominent role for the specialist physician as consultant, educator and primary provider for the more severely ill.

Guideline implementation needs research The researchers conducted the review with

reference to the 1993 AHCPR* guidelines for the primary-care treatment of major depression, noting that the guideline's 'potential to improve patient outcomes and reduce practice variation was not totally fulfilled'. The method of implementing these guidelines in routine practice remains one of the subjects of future research in this field, they note. * US Agency for Health Care Policy and Research Schulberg He. Katon W. Simon GE. Rush AJ. Treating major depression in primary care practice: an update of the Agency for Health Care Policy and Research Practice Guidelines. Archives of General Psychiatry 55: 1121-1127. Dec 1998 800730>04

PharmacoEconomics & CIuIcomes News 30 Jan 1I11III No. 197 1173-5503I99/0197-OOO2I$01.orf> Adlalnt8matlonal Um1t8cl1111111. All rlghta ~