Care pathways for people with major depressive disorder : A European Brain Council Value of Treatment study
(2022) In European Psychiatry 65(1).- Abstract
Background Despite well-established guidelines for managing major depressive disorder, its extensive disability burden persists. This Value of Treatment mission from the European Brain Council aimed to elucidate the nature and extent of gaps between best-practice and current-practice care, specifically to: 1. Identify current treatment gaps along the care pathway and determine the extent of these gaps in comparison with the stepped-care model and 2. Recommend policies intending to better meet patient needs (i.e., minimize treatment gaps). Methods After agreement upon a set of relevant treatment gaps, data pertaining to each gap were gathered and synthesized from several sources across six European countries. Subsequently, a modified... (More)
Background Despite well-established guidelines for managing major depressive disorder, its extensive disability burden persists. This Value of Treatment mission from the European Brain Council aimed to elucidate the nature and extent of gaps between best-practice and current-practice care, specifically to: 1. Identify current treatment gaps along the care pathway and determine the extent of these gaps in comparison with the stepped-care model and 2. Recommend policies intending to better meet patient needs (i.e., minimize treatment gaps). Methods After agreement upon a set of relevant treatment gaps, data pertaining to each gap were gathered and synthesized from several sources across six European countries. Subsequently, a modified Delphi approach was undertaken to attain consensus among an expert panel on proposed recommendations for minimizing treatment gaps. Results Four recommendations were made to increase the depression diagnosis rate (from ∼50% episodes), aiming to both increase the number of patients seeking help, and the likelihood of a practitioner to correctly detect depression. These should reduce time to treatment (from ∼1 to ∼8Â years after illness onset) and increase rates of treatment; nine further recommendations aimed to increase rates of treatment (from ∼25 to ∼50% of patients currently treated), mainly focused on targeting the best treatment to each patient. To improve follow-up after treatment initiation (from ∼30 to ∼65% followed up within 3Af; months), seven recommendations focused on increasing continuity of care. For those not responding, 10 recommendations focused on ensuring access to more specialist care (currently at rates of ∼5-25% of patients). Conclusions The treatment gaps in depression care are substantial and concerning, from the proportion of people not entering care pathways to those stagnating in primary care with impairing and persistent illness. A wide range of recommendations can be made to enhance care throughout the pathway.
(Less)
- author
- Strawbridge, Rebecca
; Mccrone, Paul
; Ulrichsen, Andrea
; Zahn, Roland
; Eberhard, Jonas
LU
; Wasserman, Danuta
; Brambilla, Paolo
; Schiena, Giandomenico
; Hegerl, Ulrich
; Balazs, Judit
; Caldas De Almeida, Jose
; Antunes, Ana
LU
; Baltzis, Spyridon
LU
; Carli, Vladmir
; Quoidbach, Vinciane
; Boyer, Patrice
and Young, Allan H.
(Less) - organization
- publishing date
- 2022-06-15
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Care pathways, diagnosis, major depressive disorder, treatment
- in
- European Psychiatry
- volume
- 65
- issue
- 1
- article number
- e36
- publisher
- Elsevier Masson SAS
- external identifiers
-
- scopus:85132860973
- pmid:35703080
- ISSN
- 0924-9338
- DOI
- 10.1192/j.eurpsy.2022.28
- language
- English
- LU publication?
- yes
- id
- 13f85271-4d58-4779-a3ec-b3487f501d8f
- date added to LUP
- 2022-10-04 11:56:03
- date last changed
- 2025-01-11 13:56:47
@article{13f85271-4d58-4779-a3ec-b3487f501d8f,
abstract = {{<p>Background Despite well-established guidelines for managing major depressive disorder, its extensive disability burden persists. This Value of Treatment mission from the European Brain Council aimed to elucidate the nature and extent of gaps between best-practice and current-practice care, specifically to: 1. Identify current treatment gaps along the care pathway and determine the extent of these gaps in comparison with the stepped-care model and 2. Recommend policies intending to better meet patient needs (i.e., minimize treatment gaps). Methods After agreement upon a set of relevant treatment gaps, data pertaining to each gap were gathered and synthesized from several sources across six European countries. Subsequently, a modified Delphi approach was undertaken to attain consensus among an expert panel on proposed recommendations for minimizing treatment gaps. Results Four recommendations were made to increase the depression diagnosis rate (from ∼50% episodes), aiming to both increase the number of patients seeking help, and the likelihood of a practitioner to correctly detect depression. These should reduce time to treatment (from ∼1 to ∼8Â years after illness onset) and increase rates of treatment; nine further recommendations aimed to increase rates of treatment (from ∼25 to ∼50% of patients currently treated), mainly focused on targeting the best treatment to each patient. To improve follow-up after treatment initiation (from ∼30 to ∼65% followed up within 3Af; months), seven recommendations focused on increasing continuity of care. For those not responding, 10 recommendations focused on ensuring access to more specialist care (currently at rates of ∼5-25% of patients). Conclusions The treatment gaps in depression care are substantial and concerning, from the proportion of people not entering care pathways to those stagnating in primary care with impairing and persistent illness. A wide range of recommendations can be made to enhance care throughout the pathway.</p>}},
author = {{Strawbridge, Rebecca and Mccrone, Paul and Ulrichsen, Andrea and Zahn, Roland and Eberhard, Jonas and Wasserman, Danuta and Brambilla, Paolo and Schiena, Giandomenico and Hegerl, Ulrich and Balazs, Judit and Caldas De Almeida, Jose and Antunes, Ana and Baltzis, Spyridon and Carli, Vladmir and Quoidbach, Vinciane and Boyer, Patrice and Young, Allan H.}},
issn = {{0924-9338}},
keywords = {{Care pathways; diagnosis; major depressive disorder; treatment}},
language = {{eng}},
month = {{06}},
number = {{1}},
publisher = {{Elsevier Masson SAS}},
series = {{European Psychiatry}},
title = {{Care pathways for people with major depressive disorder : A European Brain Council Value of Treatment study}},
url = {{http://dx.doi.org/10.1192/j.eurpsy.2022.28}},
doi = {{10.1192/j.eurpsy.2022.28}},
volume = {{65}},
year = {{2022}},
}