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How could depression guidelines be made more relevant and applicable to primary care?

Hegarty, Kelsey, Gunn, Jane, Blashki, Grant, Griffiths, Frances, Dowell, Tony and Kendrick, Tony (2009) How could depression guidelines be made more relevant and applicable to primary care? British Journal of General Practice, 59, (562), e149-e156. (doi:10.3399/bjgp09X420581).

Record type: Article


Many guidelines have been developed in the area of depression but there has been no systematic assessment of their relevance to general practice.
To assess national guidelines on general practice management of depression using two complementary approaches to identify specific ways in which guidance could be made more relevant and applicable to the nature of general practice and the patients who seek help in this context.
Design of study
Review of national guidelines.
Seven English speaking countries: UK, US, Australia, New Zealand, Ireland, Canada, and Singapore.
Seven guidelines were independently reviewed quantitatively using the Appraisal of Guidelines for Research and Evaluation (AGREE) scores and qualitatively using thematic coding.
The quantitative assessment highlights that most of the guidelines fail to meet the criteria on rigour of development, applicability, and editorial independence. The qualitative assessment shows that the majority of guidelines do not address associated risk factors sufficiently and the dilemma of diagnostic uncertainty flows over into management recommendations. Management strategies for depression (antidepressants and psychological strategies) are supported by all of the guidelines, with several listing drugs before psychological therapies; there is limited attention paid to the different types of psychological therapies. Moreover, the guidelines in the main fail to acknowledge individual patient circumstances, in particular the influence on response to treatment of social issues such as adverse life events or social support.
Assessments of current national guidelines on depression management in general practice suggest significant limitations in their relevance to general practice.

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More information

Published date: May 2009
Keywords: appraisal, depression, guidelines


Local EPrints ID: 68823
ISSN: 0960-1643
PURE UUID: 65984b70-473c-44da-b66c-90c948249ac3
ORCID for Tony Kendrick: ORCID iD

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Date deposited: 06 Oct 2009
Last modified: 19 Jul 2017 00:15

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Author: Kelsey Hegarty
Author: Jane Gunn
Author: Grant Blashki
Author: Frances Griffiths
Author: Tony Dowell
Author: Tony Kendrick ORCID iD

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