1. www.gu.se Regular patient centred consultations and continuous use of a self-rating scale; effects on depression and quality of life. A randomized controlled study of structured treatment of mild to moderate depression in primary care Wikberg C, Björkelund C, Petersson E-L, Westman J, Baigi A Dept of Public Health and Community Medicine/Section of Primary Health Care, the Sahlgrenska Academy, University of Gothenburg.

2. www.gu.se Background Depression is one of the major causes of illness with an estimated prevalence of 10% and causes lowered functional capacity and reduced quality of life. Effects of structured patient centred treatment, and the use of self- rating scales in primary care is not yet properly studied.

3. www.gu.se Aim To study effects of regularpatient centered consultations with repeated use of self-rating scales on mild-moderate depression in the primary care setting.

4. www.gu.se Method GPs are randomized either to control group (treatment as usual) or intervention group. The study population consists of primary care attendees aged 18 and up with diagnosis of mild to moderate depression (DSM-IV). Intervention study population is offered frequent patient centred consultations (regular visits 4 times during 12 weeks) with continuous use of self-rating scale MADRS-S to monitor depression course, in addition to treatment as usual. Control study population gets treatment as usual. At baseline and after 12 weeks BDI-II and EQ-5D are used to measure depression and QoL in both groups of study population (by a study nurse)

5. www.gu.se MADRS-S GP Randomisation GP InterventionGP Control Treatment as usual Baseline N= 200 BDI-II, EQ5D GP ControlGP Intervention 4 weeks 8 weeks 12 weeks Treatment as usual PLUS Method

6. www.gu.se Group 1. Group 2. Results halfway…

7. www.gu.se If the intervention group shows significantly better results on reducing depression and increasing quality of life it can change the way we approach depression treatment – on the other hand, if no differences can be shown – both managements are good enough... Discussion

8. www.gu.se Take home message. Trials runs smoother with a research nurse (or other profession) on site.(almost 24/7) Each site is unique, and requires tailor made solutions in addition to GCP.

9. www.gu.se Thank You all for your attention!