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Local adaptation of guidelines for identifying mental disorders in primary care may not improve patient outcomes

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QUESTION: Does local adaptation and dissemination of the WHO ICD-I0 Primary Health Care Guidelines for Diagnosis and Management of Mental Disorders improve patient outcomes?

Design

Cluster randomised trial. Practices were randomised in pairs after stratification by practice social deprivation score. It is unclear whether outcome assessors were blind to intervention allocation.

Setting

Urban and rural primary care practises in Bristol, United Kingdom; October 1997—May 1999.

Participants

Primary care practices were the unit of randomisation and analysis. 30 practices with 250 general practitioners, locums, and assistants were included. The mean practice list size was about 4200 (range 900–7300).

Intervention

Half of the practices received a guideline intervention and the other half received no intervention. The intervention involved local development and dissemination of the WHO ICD-10 Primary Health Care …

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    Author Declaration

    The Evaluating Guideline Outcomes (EGO) study was funded by the Department of Health (grant reference JRI26/0634).

    TJC was supported by a Medical Research Council (MRC) Training Fellowship in Health Services Research.

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