Effects on depression pharmacotherapy of a Dutch general practitioner training program

Background: General practitioners’ (GPs) ability to recognize, diagnose and treat depression improved significantly after a comprehensive, 20-h training programme. This study aims to evaluate in more detail the effects of the training on GPs’ pharmacotherapy of depression and related issues. Methods: A pretest–posttest design was used. Both in the pre- and post-training phase, a sample was drawn from consecutive patients of the 17 participating GPs. In the pre-training phase we identified a sample of 31 cases with an ICD-10 depression who received an antidepressant from their GP. The sample was followed for 1 year. Outcome measures were: type of antidepressant, dosage, duration and number of target instructions given by the GP. Then we trained the GPs. In the post-training phase, we identified a new sample (n=47) from their practices and measured the same outcomes. Results: Improvements were seen in choice for modern antidepressant, adequate dosage, adequate duration, and number of target instructions given. Limitations: Observed changes can be due to a period effect, inherent in a pre-post design. Conclusions: A post-academic hands-on training of GPs can improve depression pharmacotherapy according to clinical guidelines with respect to choice of a modern antidepressant, adequate dosage, adequate duration and psychoeducation.