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Decision support for primary care clinicians improves process of care but not symptoms in people with depression

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Q Does decision support for primary care clinicians improve outcomes for people with depression?


Embedded ImageDesign:

Cluster randomised controlled trial (clinicians randomised).

Embedded ImageAllocation:


Embedded ImageBlinding:

Single blind (assessors blinded).

Embedded ImageFollow-up period:

Twelve months.

Embedded ImageSetting:

Three urban and two rural primary care clinics at a Veterans Affairs Medical Centre, USA; recruitment July 2002 to October 2003.

Embedded ImagePatients:

Forty one primary care clinicians were randomised and all their patients with moderate to severe depression (Patient Health Questionnaire (PHQ-9) score between 10 and 25 or Hopkins Symptom Checklist 20 (SCL-20) score >1) were eligible for inclusion. 375 patients met inclusion criteria and enrolled. Patient exclusions: very severe depression (PHQ-9 score >9); active dangerous ideation; psychotic disorder; dementia; bipolar disorder; treated by mental health specialist in preceding 6 months; or terminally ill.

Embedded ImageIntervention:

Depression decision support or usual care. Depression decision support: …

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  • For correspondence: Steven K Dobscha, MD, Portland Veterans Affairs Medical Center, PO Box 1034 (P3MHDC), Portland, Oregon 97207, USA; steven.dobscha{at}

  • Source of funding: Veterans Affairs Health Services Research & Development Service, USA.


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