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Practice based education did not increase primary care physician recognition of depression nor improve the outcome of depression

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QUESTION: In primary care, is an education programme based on a clinical practice guideline effective in improving the recognition and outcome of depression?

Design

Cluster randomised (allocation concealed*), unblinded*, controlled trial with 6 months of follow up.

Setting

59 primary care practices in an English health district, UK.

Patients

21 409 patients attending the surgeries of 152 physicians were screened. Exclusion criteria were <16 years of age or too unwell to complete the questionnaire.

Intervention

29 practices (3 withdrew leaving 26 practices with 64 physicians) were allocated to the education group and 30 (1 was excluded leaving 29 practices with 88 physicians) were allocated to the control group. Education using a clinical practice guideline (recommended tricyclic antidepressants as first line treatment and advised physicians to aim for a dose …

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