Recruiting and retaining GPs and patients in intervention studies: the DEPS-GP project as a case study

Williamson, Michelle; Pirkis, Jane; Pfaff, Jon J.; Tyson, Orla; Sim, Moira; Kerse, Ngaire; Lautenschlager, Nicola T.; Stocks, Nigel; Almeida, Osvaldo P.

doi:10.1186/1471-2288-7-42

Cited by 80 publications

(97 citation statements)

References 11 publications

(24 reference statements)

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“…Our results are also in line with previous surveys that reported relatively low prevalence of major depression in older age (Trollor et al, 2007), although subsyndromal depression may be more common and perhaps as disabling (Snowdon, 2001), suggesting that future studies might need to take such a factor into account. Finally, our data were derived from a trial of education of general practitioners (GPs) about depression and self-harm behavior (Williamson et al, 2007). Data from the trial showed that the intervention was not associated with a decline in the prevalence of depression, although it did reduce suicide ideation (Almeida et al, 2012).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Anxiety, depression, and comorbid anxiety and depression: risk factors and outcome over two years

Almeida

Draper

Pirkis

et al. 2012

Int. Psychogeriatr.

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109

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Section: Discussionmentioning

confidence: 99%

“…Details regarding the recruitment have been reported elsewhere (Williamson et al, 2007;Almeida et al, 2011). Between May and December 2005, each patient aged 60 years or over of participating primary care practices was sent a questionnaire.…”

Section: Study Design and Participantsmentioning

confidence: 99%

Anxiety, depression, and comorbid anxiety and depression: risk factors and outcome over two years

Almeida

Draper

Pirkis

et al. 2012

Int. Psychogeriatr.

Self Cite

109

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“…Details regarding the recruitment of general practitioners and their patients have been reported elsewhere (Williamson et al, 2007). Between May and December 2005 each patient on the practice list was sent a self-completion questionnaire, a personalized cover letter from their general practitioner, project information, a consent form and a reply-paid envelope addressed to the project office.…”

Section: Study Design and Participantsmentioning

confidence: 99%

A practical approach to assess depression risk and to guide risk reduction strategies in later life

Almeida

Alfonso

Pirkis

et al. 2010

Int. Psychogeriatr.

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Background:Many factors have been associated with the onset and maintenance of depressive symptoms in later life, although this knowledge is yet to be translated into significant health gains for the population. This study gathered information about common modifiable and non-modifiable risk factors for depression with the aim of developing a practical probabilistic model of depression that can be used to guide risk reduction strategies.Methods:A cross-sectional study was undertaken of 20,677 community-dwelling Australians aged 60 years or over in contact with their general practitioner during the preceding 12 months. Prevalent depression (minor or major) according to the Patient Health Questionnaire (PHQ-9) assessment was the main outcome of interest. Other measured exposures included self-reported age, gender, education, loss of mother or father before age 15 years, physical or sexual abuse before age 15 years, marital status, financial stress, social support, smoking and alcohol use, physical activity, obesity, diabetes, hypertension, and prevalent cardiovascular diseases, chronic respiratory diseases and cancer.Results:The mean age of participants was 71.7 ± 7.6 years and 57.9% were women. Depression was present in 1665 (8.0%) of our subjects. Multivariate logistic regression showed depression was independently associated with age older than 75 years, childhood adverse experiences, adverse lifestyle practices (smoking, risk alcohol use, physical inactivity), intermediate health hazards (obesity, diabetes and hypertension), comorbid medical conditions (clinical history of coronary heart disease, stroke, asthma, chronic obstructive pulmonary disease, emphysema or cancers), and social or financial strain. We stratified the exposures to build a matrix that showed that the probability of depression increased progressively with the accumulation of risk factors, from less than 3% for those with no adverse factors to more than 80% for people reporting the maximum number of risk factors.Conclusions:Our probabilistic matrix can be used to estimate depression risk and to guide the introduction of risk reduction strategies. Future studies should now aim to clarify whether interventions designed to mitigate the impact of risk factors can change the prevalence and incidence of depression in later life.

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“…The qualitative interviews in practices comprised a low proportion of GPs and a higher proportion of reception staff. This could reflect the reported difficulties in getting GPs to engage with the initiative, or a more general reluctance of GPs to take part in research, which is well documented (Borgiel et al, 1989;Silagy and Carson, 1989;Bell-Syer and Moffett, 2000;Askew et al, 2002;Williamson et al, 2007). It could, alternatively, be seen as being appropriate to the way the initiative was implemented, as receptionist triage was consistently adopted within the practices, while changes involving GPs were rather less prominent.…”

Section: Methodological Limitationsmentioning

confidence: 99%

Self-care in primary care: findings from a longitudinal comparison study

Bagnall

South

Forshaw

et al. 2012

Prim Health Care Res Dev

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Aim: To examine the effects of self-care training workshops for primary healthcare workers on frequently attending patients. Background: Interventions to promote selfcare in frequent users of primary care services have had mixed results. This paper reports an evaluation of a self-care initiative that aimed to develop a practice-based strategy to support self-care. Methods: A 12-month longitudinal-matched comparison study was carried out in seven intervention and four comparison practices. The intervention was a multidisciplinary training package delivered to Primary Care Trusts (PCTs) and practice staff in three workshops, over a three-to six-month period. Twenty-one managers, health professionals and other staff from participating practices and PCTs and 1454 patients were involved in the study. 'Frequently attending' patients were defined as having visited the practice more than eight times in the previous year, and were identified from practice registers and recruited by letter.Three sets of data were obtained: psychometric scores and other data from structured questionnaires; routinely collected data on use of healthcare services; and self-care beliefs and behaviour from qualitative interviews. Findings: Study recruitment rate was 20% and retention rate 75%. Of those recruited 66% were female and the majority (94.8%) were White. There was poor uptake of the training programme within the participating practices, with few changes agreed or implemented. Few healthcare professionals consented to take part in the evaluation. No significant changes were seen in patients' use of health services, psychometric scores or self-care beliefs or behaviour. Conclusion: The initiative did not show any effects during its pilot phase. Uptake and implementation were adversely affected by competing pressures for time and resources in primary care, coupled with a lack of engagement from primary health care professionals. IntroductionA substantial proportion of a General Practice's workload can be attributed to a relatively small proportion of the practice population who attend frequently. Definitions of 'frequent' attendance vary from threshold numbers of visits to a fixed proportion of patients with the highest consultation rate (Vedsted and Christensen, 2005). One systematic review reported that most studies used a definition of 9-14 visits per year (Gill and Sharpe, 1999), while a later review found the top 10% of attenders accounted for 30-50% of all contacts (Vedsted and Christensen, 2005). In the United Kingdom, analysis of appointment data from nine Sheffield Practices for 1997-1998 found that frequent attenders (attending more than 19 times per year) comprised 1.3% of the patient population, but generated 8.3% of consultations (Eve et al., 2000). Other UK studies, one in an isolated rural practice and one in a large teaching practice, found that frequent attenders (attending more than 11 times per year) created five times the consultation workload of a similar group (Heywood et al., 1998;Stewart and O'Dowd, 2002). The la...

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Recruiting and retaining GPs and patients in intervention studies: the DEPS-GP project as a case study

Abstract: Background: Recruiting and retaining GPs for research can prove difficult, and may result in sub-optimal patient participation where GPs are required to recruit patients. Low participation rates may affect the validity of research.

Cited by 80 publications

References 11 publications

Anxiety, depression, and comorbid anxiety and depression: risk factors and outcome over two years

Anxiety, depression, and comorbid anxiety and depression: risk factors and outcome over two years

A practical approach to assess depression risk and to guide risk reduction strategies in later life

Self-care in primary care: findings from a longitudinal comparison study

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