BACKGROUND: In 2009, a new indicator (DEP 3) was introduced into the Quality and Outcomes Framework. GPs are now encouraged to assess response to antidepressant treatment 5-12 weeks after the initial assessment, to guide clinical decision making. The Patient Health Questionnaire (PHQ-9) is one of the validated instruments that GPs can use to assess the patient's clinical state. AIMS: To explore the extent to which changes in PHQ-9 score over time reflect patients' accounts of their experiences of depression during the same period; and to explore patients' experiences of using the PHQ-9 within primary care consultations. DESIGN OF STUDY: Mixed methods. SETTING: Primary care. METHOD: Patients were recruited through six GP practices. The PHQ-9 and in-depth interviews were used at the same three time points over a 6-month period during a new or first episode of depression. RESULTS: Patterns in the total PHQ-9 score broadly reflected patients' accounts of the severity of their depression over time. However, the PHQ-9 was inaccurate in its assessment of the presence and intensity of thoughts of self-harm, and missed symptoms that are meaningful to patients. At the diagnostic primary care consultation, patients viewed their score as a 'tangible' measure of their condition. Some patients requested the PHQ-9 subsequently as a way to measure their own treatment response and recovery process. CONCLUSION: The potential therapeutic value of the PHQ-9 may be dependent upon the GP's willingness to openly discuss the results and what they may mean for the patient.
BACKGROUND: In 2009, a new indicator (DEP 3) was introduced into the Quality and Outcomes Framework. GPs are now encouraged to assess response to antidepressant treatment 5-12 weeks after the initial assessment, to guide clinical decision making. The Patient Health Questionnaire (PHQ-9) is one of the validated instruments that GPs can use to assess the patient's clinical state. AIMS: To explore the extent to which changes in PHQ-9 score over time reflect patients' accounts of their experiences of depression during the same period; and to explore patients' experiences of using the PHQ-9 within primary care consultations. DESIGN OF STUDY: Mixed methods. SETTING: Primary care. METHOD:Patients were recruited through six GP practices. The PHQ-9 and in-depth interviews were used at the same three time points over a 6-month period during a new or first episode of depression. RESULTS: Patterns in the total PHQ-9 score broadly reflected patients' accounts of the severity of their depression over time. However, the PHQ-9 was inaccurate in its assessment of the presence and intensity of thoughts of self-harm, and missed symptoms that are meaningful to patients. At the diagnostic primary care consultation, patients viewed their score as a 'tangible' measure of their condition. Some patients requested the PHQ-9 subsequently as a way to measure their own treatment response and recovery process. CONCLUSION: The potential therapeutic value of the PHQ-9 may be dependent upon the GP's willingness to openly discuss the results and what they may mean for the patient.
Authors: Geraldine M Leydon; Christopher F Dowrick; Anita S McBride; Hana J Burgess; Amanda C Howe; Pamela D Clarke; Susan P Maisey; Tony Kendrick Journal: Br J Gen Pract Date: 2011-02 Impact factor: 5.386
Authors: Ajay Thapar; Gemma Hammerton; Stephan Collishaw; Robert Potter; Frances Rice; Gordon Harold; Nicholas Craddock; Anita Thapar; Daniel J Smith Journal: Br J Gen Pract Date: 2014-01 Impact factor: 5.386
Authors: Alice Malpass; Chris Dowrick; Simon Gilbody; Jude Robinson; Nicola Wiles; Larisa Duffy; Glyn Lewis Journal: Br J Gen Pract Date: 2016-02 Impact factor: 5.386