Computerised patient-specific guidelines for management of common mental disorders in primary care: a randomised controlled trial

H. V. Thomas, G. Lewis, Margaret Camilla Watson, T. Bell, I. Lyons, K. Lloyd, S. Weich, D. Sharp

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Background: A large proportion of people with depression and anxiety go unrecognised by their general practitioner (GP). case finding does not appear to be effective on its own.

Aim: To compare the effectiveness of case-finding followed by computer-generated patient-specific guidelines with usual care for the management of common mental disorders in primary care.

Design of study: Individual patient randomised controlled trial.

Setting: Five general practices in Bristol and Cardiff

Method: 762 individuals aged greater than or equal to16 years scoring greater than or equal to12 on the Clinical Interview Schedule Revised were randomised. The experimental intervention required participants to complete a computerised psychosocial assessment that generated a report for the GP including patient-specific treatment recommendations The control patients were treated as usual with access to locally agreed guidelines Results: Participants' 12-item General Health Questionnaire (GHQ) score dropped irrespective of treatment allocation. The experimental group had a significantly lower GHQ score at 6 weeks, but not at 6 months. Rdcovery at 6 months was 3% greater among those receiving the experimental intervention (9596 confidence interval [CI] = -4 to 10). Treatment was not significantly associated with quality of life or patient satisfaction.

Conclusion: Only small benefits are like from using case finding followed by patient-specific guidelines to improve clinical management of common mental disorders in primary care. However depression and anxiety are important public health problems so the utility of such systems should be further investigated.

Original languageEnglish
Pages (from-to)832-837
Number of pages5
JournalThe British Journal of General Practice
Volume54
Issue number508
Publication statusPublished - 2004

Keywords

  • computer-assisted decision making
  • randomised controlled trial
  • primary health care
  • mental disorders
  • PSYCHIATRIC-DISORDER
  • IMPROVE TREATMENT
  • DECISION-SUPPORT
  • MEDICAL-PRACTICE
  • GENERAL-PRACTICE
  • DEPRESSION
  • ANXIETY
  • RECOGNITION
  • REVISION

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