Improvement in the service provided to patients with depression in primary care

Objective: Depression is frequently found in primary care and needs an integral approach with antidepressant treatment for an appropriate period and psychological support. The aim of this study was to evaluate the quality of the care given to patients with depression in a primary care center. Patients and method: The study design was cross-sectional and descriptive. The study population consisted of patients diagnosed with depression (n = 1.574). Systematic random sampling was performed (alpha = 0.05; power = 0.90; n= 138). The dimensions evaluated were scientific-technical quality, continuity, accessibility, and adaptation. The following explicit criteria were used: indication for antidepressant treatment; duration of antidepressant treatment > 6 months; evaluation of suicide risk; non-pharmacological antidepressant intervention; and absence gender bias in criteria (the t-test was used for quantitative variable and the chi(2) test was used for qualitative variables; alpha = 0.05). Results: A total of 79.9% of the patients were women with a mean age of 51.96 +/- 1.36 years. Associated anxiety was found in 46.8% and somatic symptoms were found in 49.6%; 64% habitually took benzodiazepines. The mean number of medical appointments per year was 9.4 +/- 0.58. Criteria were fulfilled in the following percentages: antidepressant treatment, 79.9%; the mean duration of antidepressant treatment was 12.57 +/- 1.21 months; treatment duration for at least 6 months, 69.1%; evaluation of suicide risk, 12.2%; non-pharmacological interventions, 29.5%. No significant differences were found between men and women in any of the quality criteria. Conclusions: The profile of the depressed patient is a middle-aged woman with anxiety and somatic symptoms who makes frequent visits and is undergoing treatment with antidepressants and benzodiazepines. Treatment duration was sufficient. Suicide risk was infrequently evaluated and few non-pharmacological interventions were provided. No gender bias was found.