Management of Depression in Primary Care in Catalonia: A Mixed- method Study

Abstract

Purpose Consultations related to major depression have increased significantly in recent years in Primary Care (PC) in Catalonia. PC is key in the approach, so we analysed the training and alignment with clinical practice guidelines (CPG) of PC professionals in Catalonia and explored their perceptions of the results obtained. Methods Explanatory sequential study. Cross-sectional observational study through surveys carried out on nursing and medical professionals and community emotional wellness referents (RBEC), followed by a qualitative study of phenomenological design through focus groups in the same disciplines. Results Most professionals feel poorly trained (63.5%) and do not consider themselves aligned (58.3%) with the CPG. In the focus groups, there was a widespread awareness of the PC approach to depression. It was detected that the lack of homogeneity in clinical practice is due to a lack of both time and resources, and a predominantly pharmacological approach. It was expressed that practical training focused on PC, together with collaborative care, unification of CPG and working with the social determinants of health could help in homogenisation. However, a certain reluctance towards eHealth in the approach to depression was detected. Conclusions It has been detected that professionals feel poorly trained and aligned with CPG. However, the qualitative study has made it possible to analyse the enabling factors that may explain the results obtained. The detailed analysis that has been performed may help in the development of specific strategies to improve the approach to depression in PC in Catalonia, as well as the implementation of technology in the process.