Chile: Acceptability of a Training Program for Depression Management in Primary Care

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.

Advancing Global Health Through Primary Care Physician Education on Suicide Prevention

“…Several other projects and initiatives have been implemented globally with a focus on training GPs in countries such the UK, Australia, Chile, the US, Germany, and Japan. These initiatives have shown promising results in terms of screening rates for mental health conditions, improving the appropriate prescription of antidepressants and ultimately contributing to a reduction in suicide rates [26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41].…”

Delphi-validation of a Psychotherapeutic Competencies Training Protocol (PCTP) for the treatment of depression in primary care: evidence-based practice and practice-based evidence (Validación Delphi de un Protocolo de Entrenamiento en Competencias Psicoterapéuticas (PECP) para el tratamiento de la depresión en atención primaria: práctica basada en la evidencia y evidencia basada en la práctica)

“…PHC treats all patients with depression in the public health system, except those with high suicide risk, bipolar depression or treatment-resistant depression, who are referred to specialized centres (MINSAL, 2013). Nevertheless, several deficiencies have been identified in depression management that result from health professionals’ insufficient training and competencies (Acuña et al, 2016; Alvarado & Rojas, 2011; Marín et al, 2016; Scharager & Molina, 2007). Some of the problems described are the lack of tools to perform adequate diagnoses, apply the clinical guideline and estimate the severity of depression and the high dropout rates (Alvarado & Rojas, 2011; Alvarado et al, 2012; Vöhringer et al, 2013).…”

“…La APS trata a todos los pacientes con depresión a través del sistema de salud pública, excepto a aquellos con alto riesgo de suicidio, depresión bipolar, o depresión resistente a los tratamientos; dichos pacientes son derivados a centros especializados (MINSAL, 2013). Sin embargo, se han identificado varias deficiencias en el manejo de la depresión que son el resultado de la entrenamiento y las competencias insuficientes de los profesionales de la salud (Acuña et al, 2016; Alvarado & Rojas, 2011; Marín et al, 2016; Scharager & Molina, 2007). Algunos de los problemas descritos son la falta de herramientas para realizar diagnósticos adecuados, aplicar las guías clínicas, para estimar la gravedad de la depresión y las altas tasas de abandono (Alvarado & Rojas, 2011; Alvarado et al, 2012; Vöhringer et al, 2013).…”

Competencias para el manejo psicoterapéutico de la depresión en contextos institucionales y APS: aprendiendo de la perspectiva de sus protagonistas

“…En Chile existe un programa en atención primaria de salud (APS) para la detección, diagnóstico y tratamiento integral de la depresión, que combina intervenciones médicas y psicosociales, las cuales han sido presentadas en la Guía Clínica del 2013 (MINSAL, 2013). Sin embargo, diversos autores han remarcado una serie de inconsistencias en el manejo de la depresión, que resultan de una insuficiente capacitación y falta de competencias psicoterapéuticas para tratar la depresión en este contexto (Acuña et al, 2016;Alvarado & Rojas, 2011;Bedregal, 2017;Marín et al, 2016;Minoletti & Zaccaría, 2005).…”