Clinician Guide to Depression Assessment and Management in Primary Care

Partners in Care is a real-world trial to determine whether diverse primary care practices can implement previously tested, effective models of care for depression. A collaborative effort of researchers and clinicians at many institutions, the study involves more than 27,000 patients, 125 providers, and 46 primary care clinics within six nonacademic managed care practices in various locations across the United States. The Clinician Guide is intended to increase skills, confidence, and adherence to national guidelines for depression among primary care clinicians. It uses an algorithm-based approach to sort patients into groups requiring different management actions. The algorithm helps clinicians to manage depressed patients efficiently while staying focused on the main therapeutic problems of treating major depression and dysthymia. The Clinician Guide algorithm and accompanying text cover seven assessment and seven management steps. The Guide's text is ordered to follow its algorithm, thus linking information directly to clinical actions. The Clinician Guide is based on the Agency for Healthcare Research and Quality (AHRQ, formerly AHCPR) depression guidelines, and was evaluated by four members of the AHRQ Guidelines for Depression Panel. It also incorporates comments from the many mental health specialists and primary care clinicians who participated in PIC.