Abstract
PurposeThe first aim of this qualitative study was to identify general practitioners’ (GPs’) views on depression screening combined with GP-targeted feedback in primary care. The second aim was to determine the needs and preferences of GPs with respect to GP-targeted feedback to enhance the efficacy of depression screening.MethodsA semistructured qualitative interview was conducted with officially registered GPs in Hamburg (Germany). Interviews were audio recorded and transcribed verbatim. An inductive approach was used to code the transcripts.ResultsNine GPs (27 to 70 years; 5 male) from Hamburg, Germany, participated. Regarding depression screening combined with GP-targeted feedback, five thematic groups were identified: application of screening; screening and patient–physician relationships; GPs’ attitudes towards screening; benefits and concerns related to screening; and GPs’ needs and preferences regarding feedback. While the negative aspects of screening can be described in rather general terms (e.g., screening determines the mental health competence, screening threatens the doctor–patient relationship, revealing questions harm the patients), its advantages were very specific (e.g., promoting the identification of undetected cases, relief of the daily workload, wider communication channel to reach more patients). Standardized GP-targeted feedback of the screening results was perceived as helpful and purposeful. GPs preferred feedback materials that eased their clinical workload (e.g., short text with visuals, pictures, or images).ConclusionAddressing GPs’ needs is essential when implementing depression screening tools in clinical practice. To overcome prejudices and enhance the efficacy of screening, further education for GPs on the purpose and application on depression screening may be needed. Standardized GP-targeted feedback in combination with depression screening could be the missing link to improve the detection of depression in primary care.
Highlights
Major depression is one of the most disabling disorders worldwide and affects one out of every ten individuals over their lifetime in Germany [1]
Regarding the detection of depression, general practitioners (GPs) hold the key position in most health care systems: most are diagnosed in primary care, and most antidepressants are prescribed by GPs [2]
This study was conducted in preparation of the multicenter randomized controlled trial GET.FEEDBACK.GP [14] (ClinicalTrials.gov identifier: NCT03988985), which tests a patient-targeted feedback intervention as an adjunct to depression screening in primary care
Summary
Major depression is one of the most disabling disorders worldwide and affects one out of every ten individuals over their lifetime in Germany [1]. International studies estimate that almost one out of every six patients in primary care suffers from depression [2]. Regarding the detection of depression, general practitioners (GPs) hold the key position in most health care systems: most are diagnosed in primary care, and most antidepressants are prescribed by GPs [2]. Studies show that over half of the cases remain undetected [3, 4]. To close this gap, standardized depression screening in primary care could enhance the currently low detection rates. The efficacy of standardized depression screening in primary care is largely debated [5,6,7].
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