Table 1 Quality of treatment for depression according to different indicators based on patients’ self-reported data in the Dialogue Project in 2008
From: Quality of care for major depression and its determinants: a multilevel analysis
Quality indicator | Patients (n) | Observed% (n) | Indicator description |
|---|---|---|---|
Detection of depression | 915 | 68.1% (623) | In the past 12 months, the respondent was told s/he was suffering from depression OR received an antidepressant prescription |
Use of services | |||
Use of services for mental health reason | 915 | 86.2% (789) | At least one consultation for mental health reason in the past 12 months (family doctor/ general practitioner, psychiatrist, other physicians, psychologist, nurse, social worker/counselor/ psychotherapist, other health provider or professional) |
Watchful waiting (monitoring of untreated patients) | 137 | 40.1% (55) | 3 or more medical consultation for mental health reason in the past year (among untreated respondents, i.e. respondents with at least one consultation for mental health reason in the past 12 months but no antidepressant prescription and no help in the form of psychotherapy or counseling) |
Psychotherapy | |||
Any form of psychotherapy or counseling | 789 | 56.1% (443) | Help in the form of psychotherapy or counseling in the past 12 months (among those with at least one consultation for mental health reason) |
Adequate length session for psychotherapy or counseling | 443 | 88.9% (394) | At least one session lasting 15 minutes or more of psychotherapy or counseling with one or other of the professionals consulted (among those who received help in the form of psychotherapy or counseling) |
At least one of the recommended psychotherapy | 394 | 83.2% (328) | Cognitive behavior therapy AND/OR Interpersonal therapy (among those who received at least one session for counseling of adequate length) |
Complete course of psychotherapy | 443 | 60.7% (269) | 12 or more consultations for mental health reason in the past year. According to the Canadian recommendations, a minimum of 12 visits is required for a full course of psychotherapy (among those who received help in the form of psychotherapy or counseling) |
Adequate psychotherapy | 443 | 49% (217) | At least one of the recommended psychotherapy + complete course of psychotherapy (among those who received help in the form of psychotherapy or counseling) |
Medication | |||
Antidepressant prescription in the past year | 915 | 59.5% (544) | In the past 12 months, the respondent received an antidepressant prescription |
Adequate follow-up of the prescription | 544 | 77.9% (424) | The respondent consulted 3 times or more the professional who prescribed the medication (among those who received an anti-depressant prescription) |
Compliance support | 544 | 80.1% (436) | Any one or other of the professionals who prescribed the medication helped the respondent follow the course of treatment (among those who received an anti-depressant prescription) |
Patient education about antidepressant prescription | Any one or other of the professionals who prescribed the medication provided information on the subject of… (among those who received an anti-depressant prescription) | ||
The effectiveness of treatment | 544 | 72.8% (396) | |
The possible side effects | 544 | 74.8% (407) | |
The probable length of treatment | 544 | 59.2% (322) | |
Side effects you may expect to experience if you stop taking the medication of your own accord | 544 | 61.6% (335) | |
Adequate length of treatment | 83 | 59% (49) | The respondent have been taking the antidepressant medication for 180 days or more (among those who stopped their treatment) |
Adequate dosage of antidepressant medication | 458 | 88.9% (407) | The respondent received at least one antidepressant prescription at the minimum recommended dosage (among those taking antidepressant medication at the time of interview) |
At least one minimally adequate treatment | 789 | 60.5% (477) | Adequate psychotherapy AND / OR Antidepressant prescription in the past year with adequate follow-up (≥ 3 times) (among those with at least one consultation for mental health reason or among the entire sample) |
915 | 52.2% (477) | ||
Patient education - information | |||
General patient education -information | 789 | 62.5% (493) | In the past 12 months, the respondent received information about mental health problems, existing treatments or available services (among those with at least one consultation for mental health reason) |
Specific patient education - information | The respondent received information about … (among those who received general education – information) | ||
Anxiety | 493 | 72.8% (359) | |
Depression | 493 | 83.6% (412) | |
Medication | 493 | 78.7% (388) | |
Psychotherapy | 493 | 55.6% (274) | |
Support and self-help groups in your area | 493 | 39.8% (196) | |
Information sources such as books and Internet sites | 493 | 50.3% (248) | |
Consideration of patient’s preferences | 493 | 47.1% (232) | The respondent received information about medication AND psychotherapy |
Advice or encouragement to do physical exercise | 789 | 74.7% (589) | With any one of the professionals, the respondent received advice or encouragement to do physical exercise to improve well-being, emotions and mental health (among those with at least one consultation for mental health reason) |