Adherence to Depression Practice Guidelines Could Improve Patient Outcomes

Outcomes in primary care patients with depression appear to improve when physicians follow treatment guidelines, according to a study in Annals of Internal Medicine.
The study was based on some 1100 patients in 45 practices. It found that adherence to guidelines was high for one-third of the recommendations measured, including diagnosing depression and monitoring patients over the following months. However, adherence was low for nearly half of the guideline recommendations, including adjusting treatment of patients who did not initially respond.
Among patients with the worst prognoses, the predicted probability of persistent depression at 2 years was 0.61 in those who received the lowest-quality care compared with 0.51 in those who got the best care.
In an accompanying editorial, Journal Watch Cardiology Editor-in-Chief Harlan M. Krumholz says the study "lends greater credence to the guideline recommendations and supports their use for accountability."