ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2011
Impact of the QOF and the NICE guideline in the diagnosis and management of depression: a qualitative study.
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers, 2 of them syntheses that pooled it.
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Who cites it
43 citing papers in PubMed, 2 syntheses or guidelines pooled it, 82 citations in OpenAlex.
- Perceived benefits and limitations of using patient-reported outcome measures in clinical practice with individual patients: a systematic review of qualitative studies.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2022Pooled it
- Assessing depression severity using the UK Quality and Outcomes Framework depression indicators: a systematic review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2013Pooled it
- Patient-reported outcome measures for monitoring primary care patients with depression: the PROMDEP cluster RCT and economic evaluation.Health technology assessment (Winchester, England) · 2024Trial
- Systematic depression screening in high-risk patients attending primary care: a pragmatic cluster-randomized trial.BMC psychiatry · 2013Trial
- The correlation between systemic immune-inflammation index and major depression in patients with depression.Frontiers in psychiatry · 2025Article
- Replicability and reproducibility of predictive models for diagnosis of depression among young adults using Electronic Health Records.Diagnostic and prognostic research · 2023Article
- Article
- Anxiety and Depression in People with Eczema or Psoriasis: A Comparison of Associations in UK Biobank and Linked Primary Care Data.Clinical epidemiology · 2023Article
- Temporal trends in annual incidence rates for psychiatric disorders and self-harm among children and adolescents in the UK, 2003-2018.BMC psychiatry · 2021Article
- Integrating Patient Reported Outcome Measures (PROMs) into routine nurse-led primary care for patients with multimorbidity: a feasibility and acceptability study.Health and quality of life outcomes · 2021Article
- The association between self-reported mental health, medication record and suicide risk: A population wide study.SSM - population health · 2021Article
- Transforming Population-Based Depression Care: a Quality Improvement Initiative Using Remote, Centralized Care Management.Journal of general internal medicine · 2021Observational
- Barriers to integrating routine depression screening into community low vision rehabilitation services: a mixed methods study.BMC psychiatry · 2020Article
- A pay for performance scheme in primary care: Meta-synthesis of qualitative studies on the provider experiences of the quality and outcomes framework in the UK.BMC family practice · 2020Article
- Secondary care specialist visits made by children and young people prescribed antidepressants in primary care: a descriptive study using the QResearch database.BMC medicine · 2020Article
- General practitioners' views on use of patient reported outcome measures in primary care: a cross-sectional survey and qualitative study.BMC family practice · 2020Article
- Establishing the acceptability of a brief patient reported outcome measure and feasibility of implementing it in a breast device registry - a qualitative study.Journal of patient-reported outcomes · 2019Article
- Feasibility of referral to a therapist for assessment of psychiatric problems in primary care - an interview study.BMC family practice · 2019Article
- How do patient reported outcome measures (PROMs) support clinician-patient communication and patient care? A realist synthesis.Journal of patient-reported outcomes · 2018Review
- Factors contributing to the recognition of anxiety and depression in general practice.BMC family practice · 2018Article
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe National Institute for Health and clinical Excellence (NICE) depression guideline (2004) and the updated Quality and Outcomes Framework (QOF) (2006) in general practice have introduced the concepts of screening severity assessment, for example using the Patient Health Questionnaire 9 (PHQ-9), and 'stepped care' for depression.
aimTo explore primary care practitioner perspectives on the clinical utility of the NICE guideline and the impact of the QOF on diagnosis and management of depression in routine practice. DESIGN AND
settingQualitative study using focus groups from four multidisciplinary practice teams with diverse populations in south Yorkshire.
methodFour focus groups were conducted, using a topic guide and audiotaping. There were 38 participants: GPs, nurses, doctors in training, mental health workers, and a manager. Data analysis was iterative and thematic.
resultsThe NICE guideline, with its embedded principles of holism and evidence-based practice, was viewed positively but its impact was compromised by resource and practitioner barriers to implementation. The perceived imposition of the screening questions and severity assessments (PHQ-9) with no responsive training had required practitioners to work hard to minimise negative impacts on their work, for example: constantly adapting consultations to tick boxes; avoiding triggering open displays of distress without the time to offer appropriate care; positively managing how their patients were labelled. Further confusion was experienced around the evolving content of psychological interventions for depression.
conclusionOrganisational barriers to the implementation of the NICE guideline and the limited scope of the QOF highlight the need for policy makers to work more effectively with the complex realities of general practice in order to systematically improve the quality and delivery of 'managed' care for depression.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.