ID-5184 Wonca Abstracts supplement A-K 13-10-23 - Flipbook - Page 252
WONCA 2023 Supplement 1: WONCA 2023 abstracts (A–K)
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An assessment of the generalist’s approach to depression
care: Learnings from a decade of the diamond study
Prof Jane Gunn
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Depression is mainly managed in primary care and general practitioners (GPs) are often a patient’s
first depression care contact. In 2001, Australia introduced the Better Outcomes in Mental Health Care
initiative (BOiMHC), which financially supported GPs in providing focused psychological strategies
(FPS) during patient consults.
The mixed-methods Diagnosis, Management and Outcomes of Depression in Primary Care (diamond)
study followed 789 (Victorian) primary care patients with depressive symptoms over 10 years. Using
rich patient-reported diamond outcomes, this presentation reports a meta-narrative assessment of
the generalist approach to the Australian general practice model of care for depression; and includes
details around the provision and helpfulness of FPS provided by GPs during visits.
Thematic analysis of the diamond data identified that concepts of ‘multimorbidity’ and ‘chronicity’
require a generalist approach in depression healthcare; concepts of ‘ongoing support’ and ‘listening’
underpin the need for a relational approach in depression management; and concepts of ‘direction’,
‘focus’ and ‘confidence’ drive the value of a humanistic approach in depression recovery. Data from
the diamond study identified depression trajectories over time and informed the development of a
clinical prediction tool (CPT) for depression severity with a care-navigation approach. At any one time
point, up to 220 diamond participants reported receiving some form of FPS during their visit with a GP.
An interpersonal therapy item was the most provided FPS (91.7%) and a type of CBT the least (7.6%).
Of the participants who reported receiving any type of FPS, over half (57.6%) found the FPS to be very/
extremely helpful.
This meta-narrative analysis of the diamond study confirms that the pathway to effective depression
primary care is via general practice; that the value and depth of the generalist model of care is central
to navigating that pathway; and demonstrates the helpfulness of FPS when provided by a GP.
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