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Abstract
Background: In Chile, there are inconsistencies in the management of depression in primary care settings, and the National Depression Program, currently in effect, was implemented without a standardized training program. The objective of this study is to evaluate the acceptability of a training program on the management of depression for primary care health teams.Methods: The study was a randomized controlled trial, and two primary centers from the Metropolitan Region of Santiago were randomly selected to carry out the intervention training program. Pre-post surveys were applied, to evaluate expectations and satisfaction with the intervention, respectively. Descriptive and content analysis was carried out.Result: The sample consisted of 41 health professionals, 56.1% of who reported that their expectations for the intervention were met. All of the training activities were evaluated with scores higher than 6.4 (on a 1–7 scale). The trainers, the methodology, and the learning environment were considered strengths and facilitators of the program, while the limited duration of the training, the logistical problems faced during part of the program, and the lack of educational material were viewed as weaknesses.Conclusion: The intervention was well accepted by primary health care teams. However, the clinical impact in patients still has to be evaluated.
Highlights
Among individuals attending primary care centers, an international study conducted by the World Health Organization (WHO) showed that the highest prevalence of depression was detected in Santiago, Chile (29.5%), while the lowest was in Nagasaki, Japan (2.6%; Goldberg and Lecrubier, 1995)
In response to the high prevalence of depression in primary care settings, international evidence has suggested the use of stepwise treatment with multiple components for management of the illness, offering different levels of complexity, and different combinations of psychosocial, pharmacological, and/or psychotherapy interventions, according to the severity of the case (Katon et al, 1996)
The sample consisted of 41 participants, who were health professionals from the selected Family Health Center (CESFAM) (Table 1)
Summary
In Chile, depression is one of the most common psychiatric disorders in adult population, with a six-month prevalence of 4.7% (Vicente et al, 2002) and a one-week prevalence of 5.5% (Araya et al, 2001), and it is the second leading cause of disability-adjusted life years for both sexes (Ministry of Health (Chile), 2008), making it one of the principal public health problems in the country.The results of the 2009–2010 Chilean National Health Survey indicated that 17.2% of the general population suffered from depressive symptoms in the last year, and that 21.2% reportedChile: Training Program for Depression having been diagnosed with depression at some point in their lives (Ministry of Health (Chile), 2011). In response to the high prevalence of depression in primary care settings, international evidence has suggested the use of stepwise treatment with multiple components for management of the illness, offering different levels of complexity, and different combinations of psychosocial, pharmacological, and/or psychotherapy interventions, according to the severity of the case (Katon et al, 1996). In line with these recommendations, a randomized controlled trial was carried out, taking into account the idiosyncrasies of the Chilean primary care system, in which professionals who are not physicians provide a large portion of the interventions in these centers. The objective of this study is to evaluate the acceptability of a training program on the management of depression for primary care health teams
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