S11-02 - The depression initiative. A webbased supported stepped collaborative care treatment algorithm for depressive disorder in primary care

Abstract

In the Netherlands, the Depression Initiative has been launched in 2006 as a nationwide attempt to implement the Multidisciplinary Guideline for Depression and to evaluate its cost effectiveness. Evaluation of a collaborative stepped care model in several health care settings is one of the objectives of the Depression Initiative. Currently a stepped collaborative care project is being evaluated in the primary care setting, evaluating stepped collaborative care for depressive disorder provided by the primary care practitioner, a nurse-care-manager, and a consultant psychiatrist, in a Randomised Controlled Trial. 150 Patients with depressive disorder are offered a treatment plan. They can choose from two options: Problem Solving Treatment with or without antidepressant treatment. The medication is prescribed by the PCP, PST and monitoring is provided by the care manager, and the psychiatrist can be consulted every 6 weeks in order to see if the intervention is sufficient to improve the symptoms of the patient. The PHQ is used for monitoring. A two step approach is aimed at; if the patient does not achieve remission after 18 weeks, the patient is referred to mental health care. This stepwise approach is supported by a training and supervision program and by a web-based tracking system in which the care-manager and the patient can monitor progress and consult the psychiatrist. This approach is compared with Care As Usual in the primary care setting. In the presentation, preliminary results will be presented.