Care pathways for people with major depressive disorder: A European Brain Council Value of Treatment study
Abstract Background Despite well-established guidelines for managing major depressive disorder, its extensive disability burden persists. This Value of Treatment mission from the European Brain Council aimed to elucidate the nature and extent of “gaps” between best-practice and current-practice ca...
| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Cambridge University Press
2022-01-01
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| Series: | European Psychiatry |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S0924933822000281/type/journal_article |
| _version_ | 1811156309128511488 |
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| author | Rebecca Strawbridge Paul McCrone Andrea Ulrichsen Roland Zahn Jonas Eberhard Danuta Wasserman Paolo Brambilla Giandomenico Schiena Ulrich Hegerl Judit Balazs Jose Caldas de Almeida Ana Antunes Spyridon Baltzis Vladmir Carli Vinciane Quoidbach Patrice Boyer Allan H. Young |
| author_facet | Rebecca Strawbridge Paul McCrone Andrea Ulrichsen Roland Zahn Jonas Eberhard Danuta Wasserman Paolo Brambilla Giandomenico Schiena Ulrich Hegerl Judit Balazs Jose Caldas de Almeida Ana Antunes Spyridon Baltzis Vladmir Carli Vinciane Quoidbach Patrice Boyer Allan H. Young |
| author_sort | Rebecca Strawbridge |
| collection | DOAJ |
| description |
Abstract
Background
Despite well-established guidelines for managing major depressive disorder, its extensive disability burden persists. This Value of Treatment mission from the European Brain Council aimed to elucidate the nature and extent of “gaps” between best-practice and current-practice care, specifically to:
1.
Identify current treatment gaps along the care pathway and determine the extent of these gaps in comparison with the stepped-care model and
2.
Recommend policies intending to better meet patient needs (i.e., minimize treatment gaps).
Methods
After agreement upon a set of relevant treatment gaps, data pertaining to each gap were gathered and synthesized from several sources across six European countries. Subsequently, a modified Delphi approach was undertaken to attain consensus among an expert panel on proposed recommendations for minimizing treatment gaps.
Results
Four recommendations were made to increase the depression diagnosis rate (from ~50% episodes), aiming to both increase the number of patients seeking help, and the likelihood of a practitioner to correctly detect depression. These should reduce time to treatment (from ~1 to ~8 years after illness onset) and increase rates of treatment; nine further recommendations aimed to increase rates of treatment (from ~25 to ~50% of patients currently treated), mainly focused on targeting the best treatment to each patient. To improve follow-up after treatment initiation (from ~30 to ~65% followed up within 3 months), seven recommendations focused on increasing continuity of care. For those not responding, 10 recommendations focused on ensuring access to more specialist care (currently at rates of ~5–25% of patients).
Conclusions
The treatment gaps in depression care are substantial and concerning, from the proportion of people not entering care pathways to those stagnating in primary care with impairing and persistent illness. A wide range of recommendations can be made to enhance care throughout the pathway.
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| first_indexed | 2024-04-10T04:49:24Z |
| format | Article |
| id | doaj.art-7ad579d222f34514971cee0d07706dac |
| institution | Directory Open Access Journal |
| issn | 0924-9338 1778-3585 |
| language | English |
| last_indexed | 2024-04-10T04:49:24Z |
| publishDate | 2022-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | European Psychiatry |
| spelling | doaj.art-7ad579d222f34514971cee0d07706dac2023-03-09T12:33:56ZengCambridge University PressEuropean Psychiatry0924-93381778-35852022-01-016510.1192/j.eurpsy.2022.28Care pathways for people with major depressive disorder: A European Brain Council Value of Treatment studyRebecca Strawbridge0https://orcid.org/0000-0002-2984-1124Paul McCrone1https://orcid.org/0000-0001-7001-4502Andrea Ulrichsen2https://orcid.org/0000-0003-3522-0620Roland Zahn3https://orcid.org/0000-0002-8447-1453Jonas Eberhard4https://orcid.org/0000-0003-0364-2626Danuta Wasserman5https://orcid.org/0000-0002-8436-3989Paolo Brambilla6https://orcid.org/0000-0002-4021-8456Giandomenico Schiena7Ulrich Hegerl8Judit Balazs9https://orcid.org/0000-0001-6397-1419Jose Caldas de Almeida10Ana Antunes11Spyridon Baltzis12https://orcid.org/0000-0002-3475-9555Vladmir Carli13https://orcid.org/0000-0001-6922-0675Vinciane Quoidbach14https://orcid.org/0000-0002-4554-6432Patrice Boyer15Allan H. Young16Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United KingdomCentre for Mental Health, University of Greenwich, London, United KingdomDepartment of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United KingdomDepartment of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United KingdomDivision of Psychiatry, Department of Clinical Sciences, Lund University, Lund, SwedenNational Centre for Suicide Research and Prevention of Mental Ill-Health, Karolinska Institutet, Stockholm, SwedenDepartment of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy Department of Pathophysiology and Transplantation, University of Milan, Milan, ItalyDepartment of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, ItalyDepartment of Psychiatry, Psychosomatics and Psychotherapy, Goethe University, Frankfurt, GermanyInstitute of Psychology, Eötvös Loránd University, Budapest, Hungary Department of Psychology, Bjørknes University College, Oslo, NorwayChronic Diseases Research Center, Nova Medical School, Nova University of Lisbon, Lisbon, PortugalChronic Diseases Research Center, Nova Medical School, Nova University of Lisbon, Lisbon, PortugalDivision of Psychiatry, Department of Clinical Sciences, Lund University, Lund, SwedenNational Centre for Suicide Research and Prevention of Mental Ill-Health, Karolinska Institutet, Stockholm, SwedenEuropean Brain Council, Brussels, BelgiumEuropean Brain Council, Brussels, BelgiumDepartment of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom Abstract Background Despite well-established guidelines for managing major depressive disorder, its extensive disability burden persists. This Value of Treatment mission from the European Brain Council aimed to elucidate the nature and extent of “gaps” between best-practice and current-practice care, specifically to: 1. Identify current treatment gaps along the care pathway and determine the extent of these gaps in comparison with the stepped-care model and 2. Recommend policies intending to better meet patient needs (i.e., minimize treatment gaps). Methods After agreement upon a set of relevant treatment gaps, data pertaining to each gap were gathered and synthesized from several sources across six European countries. Subsequently, a modified Delphi approach was undertaken to attain consensus among an expert panel on proposed recommendations for minimizing treatment gaps. Results Four recommendations were made to increase the depression diagnosis rate (from ~50% episodes), aiming to both increase the number of patients seeking help, and the likelihood of a practitioner to correctly detect depression. These should reduce time to treatment (from ~1 to ~8 years after illness onset) and increase rates of treatment; nine further recommendations aimed to increase rates of treatment (from ~25 to ~50% of patients currently treated), mainly focused on targeting the best treatment to each patient. To improve follow-up after treatment initiation (from ~30 to ~65% followed up within 3 months), seven recommendations focused on increasing continuity of care. For those not responding, 10 recommendations focused on ensuring access to more specialist care (currently at rates of ~5–25% of patients). Conclusions The treatment gaps in depression care are substantial and concerning, from the proportion of people not entering care pathways to those stagnating in primary care with impairing and persistent illness. A wide range of recommendations can be made to enhance care throughout the pathway. https://www.cambridge.org/core/product/identifier/S0924933822000281/type/journal_articleCare pathwaysdiagnosismajor depressive disordertreatment |
| spellingShingle | Rebecca Strawbridge Paul McCrone Andrea Ulrichsen Roland Zahn Jonas Eberhard Danuta Wasserman Paolo Brambilla Giandomenico Schiena Ulrich Hegerl Judit Balazs Jose Caldas de Almeida Ana Antunes Spyridon Baltzis Vladmir Carli Vinciane Quoidbach Patrice Boyer Allan H. Young Care pathways for people with major depressive disorder: A European Brain Council Value of Treatment study European Psychiatry Care pathways diagnosis major depressive disorder treatment |
| title | Care pathways for people with major depressive disorder: A European Brain Council Value of Treatment study |
| title_full | Care pathways for people with major depressive disorder: A European Brain Council Value of Treatment study |
| title_fullStr | Care pathways for people with major depressive disorder: A European Brain Council Value of Treatment study |
| title_full_unstemmed | Care pathways for people with major depressive disorder: A European Brain Council Value of Treatment study |
| title_short | Care pathways for people with major depressive disorder: A European Brain Council Value of Treatment study |
| title_sort | care pathways for people with major depressive disorder a european brain council value of treatment study |
| topic | Care pathways diagnosis major depressive disorder treatment |
| url | https://www.cambridge.org/core/product/identifier/S0924933822000281/type/journal_article |
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