Adherence to guidelines for treatment of depression in in-patients

Schneider, Frank; Härter, Martin; Brand, Silke; Sitta, Petra; Menke, Ralph; Hammer-Filipiak, Ursula; Kudling, Ralf; Heindl, Andrea; Herold, Kurt; Frommberger, Ulrich; Elmer, Olivier; Hetzel, Günter; Witt, Gabriele; Wolfersdorf, Manfred; Berger, Thomas; Gäebel, Wolfgang

doi:10.1192/bjp.187.5.462

Cited by 48 publications

(21 citation statements)

References 18 publications

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“…The successful treatment of MDD requires close adherence to treatment plans. Those who continue therapy with their initial antidepressant are least likely to experience relapse or recurrence and those who discontinue using their antidepressant early are most likely to have relapse or recurrence (Melfi et al, 1998 (Schneider et al, 2005).…”

Section: Adherence and Attitudes To Treatmentmentioning

confidence: 99%

Suicidal Ideation and Attempts Among Psychiatric Patients With Major Depressive Disorder

Sokero¹,

Melartin²,

Rytsälä³

et al. 2003

J. Clin. Psychiatry

309

225

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Section: Adherence and Attitudes To Treatmentmentioning

confidence: 99%

Suicidal Ideation and Attempts Among Psychiatric Patients With Major Depressive Disorder

Sokero¹,

Melartin²,

Rytsälä³

et al. 2003

J. Clin. Psychiatry

309

225

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“…This corresponds to findings on depressive outpatients with up to more than half not receiving depression-specific treatment (37–39). Those numbers of patients with antidepressant treatment are unexpectedly low, at least when compared to studies on depressive inpatients (12). The role of factors such as utilization of prescription-free herbal antidepressants not registered in our prescription database or non-compliance to prescribed antidepressants remains unclear.…”

Section: Discussionmentioning

confidence: 93%

“…However, there are less prescriptions of SSRIs in Germany compared to other European countries (10). German studies also suggest a preference for other antidepressants according to the German anatomical therapeutical chemical code (ATC-index) (e.g., venlafaxine, mirtazapine) (11, 12) or for TCAs (e.g., trimipramine) (13). …”

Section: Introductionmentioning

confidence: 99%

Antidepressants: Relationship to the Time to Psychiatric Readmission and Probability of Being in Hospital in Depressive Patients

Warnke

Nordt²,

Moock

et al. 2014

Front. Public Health

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Introduction: Although antidepressants play a major role in the treatment of patients with depression, it is unclear which specific antidepressants are more efficacious than others. This study aims to analyze the relationship between several antidepressant substances and the time to readmission as well as the probability of being in hospital in a given week by using prescription data.Methods: The database was health-insurance claim data from the new Federal States in Germany. The analysis consisted of all patients with unipolar depression at their index admission in 2007 (N = 1803). Patients were followed up for 2 years after discharge from index hospitalization. Statistical analyses were conducted by discrete-time hazards models and general estimation equation models, accounting for various predictors.Results: Of all prescribed antidepressant substances, sertraline was related to an increased time to readmission by 37% and to a reduction in the probability of being in hospital in a given week by 40%. However, it was prescribed to only about 5% of the patients.Conclusion: In this study, only sertraline appeared to have clinical and economic advantages. It is remarkable that just a minority of patients received sertraline in our study, thus differing from the prescription pattern in the US.

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“…A number of studies reported substantial improvement in quality both in inpatient [1,11,14,18,21,32,50,53,57,60,62,68,78] and outpatient settings [13,29,37,40,42,46]. Numerous studies, including six RCTs [4,7,38,51,63,71], failed to show any positive effects on quality associated with practice guidelines [5,10,20,25,26,36].…”

Section: Do Practice Guidelines Improve Quality Of Care?mentioning

confidence: 99%

The Use of Three Strategies to Improve Quality of Care at a National Level

Wright

2012

Clinical Orthopaedics &Amp; Related Research

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Background Improving the quality of care is essential and a priority for patients, surgeons, and healthcare providers. Strategies to improve quality have been proposed at the national level either through accreditation standards or through national payment schemes; however, their effectiveness in improving quality is controversial. Questions/purposes The purpose of this review was to address three questions: (1) does pay-for-performance improve the quality of care; (2) do surgical safety checklists improve the quality of surgical care; and (3) do practice guidelines improve the quality of care? These three strategies were chosen because there has been some research assessing their effectiveness in improving quality, and implementation had been attempted on a large scale such as entire countries.Methods We performed a literature review from 1950 forward using Medline to identify Level I and II studies. We evaluated the three strategies and their effects on processes and outcomes of care. When possible, we examined strategy implementation, patients, and systems, including provider characteristics, which may affect the relationship between intervention and outcomes with a focus on factors that may have influenced effect size. Results Pay-for-performance improved the process and to a lesser extent the outcome of care. Surgical checklists reduced morbidity and mortality. Explicit practice guidelines influenced the process and to a lesser extent the outcome of care. Although not definitively showed, clinician involvement during development of intervention and outcomes, with explicit strategies for communication and implementation, appears to increase the likelihood of positive results. Conclusion Although the cost-effectiveness of these three strategies is unknown, quality of care could be enhanced by implementing pay-for-performance, surgical safety checklists, and explicit practice guidelines. However, this review identified that the effectiveness of these strategies is highly context-specific.

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Adherence to guidelines for treatment of depression in in-patients

Abstract: The study reveals a high standard of psychiatric treatment of in-patients with depression. Nevertheless there is still room for improvement. Differences between hospitals in adherence to guidelines indicates the need for individual application of quality management tools.

Cited by 48 publications

References 18 publications

Suicidal Ideation and Attempts Among Psychiatric Patients With Major Depressive Disorder

Suicidal Ideation and Attempts Among Psychiatric Patients With Major Depressive Disorder

Antidepressants: Relationship to the Time to Psychiatric Readmission and Probability of Being in Hospital in Depressive Patients

The Use of Three Strategies to Improve Quality of Care at a National Level

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