ArticleBMJ open2014
The effects of financial incentives for case finding for depression in patients with diabetes and coronary heart disease: interrupted time series analysis.
Article in BMJ open, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
25 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Effect of UK Quality and Outcomes Framework pay-for-performance programme on quality of primary care: systematic review with quantitative synthesis.BMJ (Clinical research ed.) · 2025Pooled it
- Payment methods for outpatient care facilities.The Cochrane database of systematic reviews · 2017Pooled it
- The REporting of studies Conducted using Observational Routinely-collected health Data (RECORD) statement.PLoS medicine · 2015Guideline
- Trial
- Trial
- Article
- What should a learning health system look like?BMJ open quality · 2025Article
- Modelling the cost-effectiveness and budget impact of pay-for-performance programs in health care.BMC health services research · 2024Article
- Comparing the effectiveness of competition as a method of reminding primary oral health care dentists to record diagnoses with two alternative methods used to enhance the recording of diagnoses in primary health care.International journal of circumpolar health · 2022Observational
- The effects of an evidence- and theory-informed feedback intervention on opioid prescribing for non-cancer pain in primary care: A controlled interrupted time series analysis.PLoS medicine · 2021Article
- The effect of electronic reminders on the recording of diagnoses in primary care: A quasi-experimental before and after study.SAGE open medicine · 2020Article
- How do community-based eye care practitioners approach depression in patients with low vision? A mixed methods study.BMC psychiatry · 2019Article
- 'Caveat emptor': the cautionary tale of endocarditis and the potential pitfalls of clinical coding data-an electronic health records study.BMC medicine · 2019Article
- Article
- Barriers and enablers to screening and diagnosing depression and diabetes distress in people with type 2 diabetes mellitus; protocol of a qualitative evidence synthesis.HRB open research · 2019Article
- Using primary care data for health research in England - an overview.Future healthcare journal · 2018Article
- Biases in electronic health record data due to processes within the healthcare system: retrospective observational study.BMJ (Clinical research ed.) · 2018Observational
- Improving the Recording of Diagnoses in Primary Care with Team Incentives: A Controlled Longitudinal Follow-Up Study.BioMed research international · 2018Observational
- A comparison of the effects of electronic reminders and group bonuses on the recording of diagnoses in primary care: a longitudinal follow-up study.BMC research notes · 2017Article
- [The REporting of studies Conducted using Observational Routinely-collected health Data (RECORD) statement].Zeitschrift fur Evidenz, Fortbildung und Qualitat im Gesundheitswesen · 2016Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
Abstract
objectiveTo evaluate the effects of Quality and Outcomes Framework (QOF) incentivised case finding for depression on diagnosis and treatment in targeted and non-targeted long-term conditions.
designInterrupted time series analysis.
settingGeneral practices in Leeds, UK.
participants65 (58%) of 112 general practices shared data on 37,229 patients with diabetes and coronary heart disease targeted by case finding incentives, and 101,008 patients with four other long-term conditions not targeted (hypertension, epilepsy, chronic obstructive pulmonary disease and asthma).
interventionIncentivised case finding for depression using two standard screening questions.
main outcome measuresClinical codes indicating new depression-related diagnoses and new prescriptions of antidepressants. We extracted routinely recorded data from February 2002 through April 2012. The number of new diagnoses and prescriptions for those on registers was modelled with a binomial regression, which provided the strength of associations between time periods and their rates.
resultsNew diagnoses of depression increased from 21 to 94/100,000 per month in targeted patients between the periods 2002-2004 and 2007-2011 (OR 2.09; 1.92 to 2.27). The rate increased from 27 to 77/100,000 per month in non-targeted patients (OR 1.53; 1.46 to 1.62). The slopes in prescribing for both groups flattened to zero immediately after QOF was introduced but before incentivised case finding (p<0.01 for both). Antidepressant prescribing in targeted patients returned to the pre-QOF secular upward trend (Wald test for equivalence of slope, z=0.73, p=0.47); the slope was less steep for non-targeted patients (z=-4.14, p<0.01).
conclusionsIncentivised case finding increased new depression-related diagnoses. The establishment of QOF disrupted rising trends in new prescriptions of antidepressants, which resumed following the introduction of incentivised case finding. Prescribing trends are of concern given that they may include people with mild-to-moderate depression unlikely to respond to such treatment.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.