Nudging General Practitioners to explore suicidal thoughts among depressed patients
Abstract Background While frank discussion of suicidal thoughts in patients with depression is important for the prevention of suicide, suicide exploration of General Practitioners (GPs) is suboptimal. This study aimed to assess whether an intervention that prompts pop-up screens nudges GPs to more...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-04-01
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| Series: | BMC Primary Care |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12875-023-02043-3 |
| _version_ | 1797853633424916480 |
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| author | Elke Elzinga Derek P. de Beurs Aartjan T.F. Beekman Otto R. Maarsingh Renske Gilissen |
| author_facet | Elke Elzinga Derek P. de Beurs Aartjan T.F. Beekman Otto R. Maarsingh Renske Gilissen |
| author_sort | Elke Elzinga |
| collection | DOAJ |
| description | Abstract Background While frank discussion of suicidal thoughts in patients with depression is important for the prevention of suicide, suicide exploration of General Practitioners (GPs) is suboptimal. This study aimed to assess whether an intervention that prompts pop-up screens nudges GPs to more frequently explore suicidal thoughts over the course of two years. Methods From January 2017 to December 2018, the intervention was incorporated in the information system of the Dutch general practice sentinel network. New registration of an episode of depression triggered a pop-up screen referring to a questionnaire about GPs’ behaviour with regard to exploring suicidal thoughts. In two years, 625 questionnaires were completed by GPs and analysed using multilevel logistic regression analyses. Results Compared to the first year, GPs were 50% more likely to explore suicidal thoughts among patients in the second year (OR 1.48; 95%CI 1.01–2.16). When adjusting for patients’ gender and age we found that the effect of the pop-up screens disappeared (OR 1.33; 95% CI 0.90–1.97). Suicide exploration occurred less frequently in women than in men (OR 0.64; 95% CI 0.43–0.98) and in older compared to younger patients (OR 0.97; 95% CI 0.96–0.98 per year older). In addition, 26% of variation in suicide exploration was because of differences in general practice. There was no evidence that general practices developed differently over time. Conclusions Although low cost and easy to administer, the pop-up system was not effective in nudging GPs to explore suicidality more frequently. We encourage studies to test whether implementing these nudges as part of a multifaceted approach will lead to a stronger effect. Moreover, we recommend researchers to include more variables, such as work experience or previous mental health training, to better understand the effects of the intervention on GPs’ behaviour. |
| first_indexed | 2024-04-09T19:53:52Z |
| format | Article |
| id | doaj.art-187ca1a24a34427d93defc577c1978e3 |
| institution | Directory Open Access Journal |
| issn | 2731-4553 |
| language | English |
| last_indexed | 2024-04-09T19:53:52Z |
| publishDate | 2023-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Primary Care |
| spelling | doaj.art-187ca1a24a34427d93defc577c1978e32023-04-03T05:35:06ZengBMCBMC Primary Care2731-45532023-04-012411710.1186/s12875-023-02043-3Nudging General Practitioners to explore suicidal thoughts among depressed patientsElke Elzinga0Derek P. de Beurs1Aartjan T.F. Beekman2Otto R. Maarsingh3Renske Gilissen4113 Suicide prevention, research departmentDepartment of Clinical Psychology, University of AmsterdamDepartment of Psychiatry, Amsterdam UMC, Vrije UniversiteitDepartment of General Practice, Amsterdam UMC, Amsterdam Public Health Research Institute113 Suicide prevention, research departmentAbstract Background While frank discussion of suicidal thoughts in patients with depression is important for the prevention of suicide, suicide exploration of General Practitioners (GPs) is suboptimal. This study aimed to assess whether an intervention that prompts pop-up screens nudges GPs to more frequently explore suicidal thoughts over the course of two years. Methods From January 2017 to December 2018, the intervention was incorporated in the information system of the Dutch general practice sentinel network. New registration of an episode of depression triggered a pop-up screen referring to a questionnaire about GPs’ behaviour with regard to exploring suicidal thoughts. In two years, 625 questionnaires were completed by GPs and analysed using multilevel logistic regression analyses. Results Compared to the first year, GPs were 50% more likely to explore suicidal thoughts among patients in the second year (OR 1.48; 95%CI 1.01–2.16). When adjusting for patients’ gender and age we found that the effect of the pop-up screens disappeared (OR 1.33; 95% CI 0.90–1.97). Suicide exploration occurred less frequently in women than in men (OR 0.64; 95% CI 0.43–0.98) and in older compared to younger patients (OR 0.97; 95% CI 0.96–0.98 per year older). In addition, 26% of variation in suicide exploration was because of differences in general practice. There was no evidence that general practices developed differently over time. Conclusions Although low cost and easy to administer, the pop-up system was not effective in nudging GPs to explore suicidality more frequently. We encourage studies to test whether implementing these nudges as part of a multifaceted approach will lead to a stronger effect. Moreover, we recommend researchers to include more variables, such as work experience or previous mental health training, to better understand the effects of the intervention on GPs’ behaviour.https://doi.org/10.1186/s12875-023-02043-3Suicide preventionSuicide explorationGeneral practitionersGeneral practiceMental healthDepression |
| spellingShingle | Elke Elzinga Derek P. de Beurs Aartjan T.F. Beekman Otto R. Maarsingh Renske Gilissen Nudging General Practitioners to explore suicidal thoughts among depressed patients BMC Primary Care Suicide prevention Suicide exploration General practitioners General practice Mental health Depression |
| title | Nudging General Practitioners to explore suicidal thoughts among depressed patients |
| title_full | Nudging General Practitioners to explore suicidal thoughts among depressed patients |
| title_fullStr | Nudging General Practitioners to explore suicidal thoughts among depressed patients |
| title_full_unstemmed | Nudging General Practitioners to explore suicidal thoughts among depressed patients |
| title_short | Nudging General Practitioners to explore suicidal thoughts among depressed patients |
| title_sort | nudging general practitioners to explore suicidal thoughts among depressed patients |
| topic | Suicide prevention Suicide exploration General practitioners General practice Mental health Depression |
| url | https://doi.org/10.1186/s12875-023-02043-3 |
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