engleski

Family Practice Depression and Multi-morbidity (FPDM): A European consensus on a diagnostic depression tool in primary care

Background: Family practice depression and Multi-morbidity is a European study aimed to prevent depression in adult multimorbid patients in primary care. A common validated diagnostic tool (effective, reliable and ergonomic) was mandatory for patient's inclusion in FPDM. Research question: What is the best (effective, reliable and ergonomics) tool for depression's diagnostic vetrsus DSM-IV in primary care for adult patients? Method: The modified RAND Appropriateness Method (RAM) or RAND/UCLA has been selected. This RAM consisted of a systematic literature review plus a consensus procedure (two Delphi rounds with an expert panel meeting inserted in between). The grup of experts was purposive. They had to be European researchers and GPs. Aim of the systematic review was to extract validated diagnostic tools versus DSM-IV. The searched effectiveness criterion was Youden index. The searched reliability criterion was Cronbach's alpha. Ergonomics data were extracted from the literature (structure, interrogation technique, duration). Results: Seven validated diagnostic tools were revealed. At the end of the first Delphi round, two instruments were considered sufficiently effective and reliable to be used: the Hospital Anxiety and depression Scale (HADS) and the Hopkins Symptoms Checklist-25 (HSCL-25). Ergonomics was tested during the panel meeting during EGPRN Antwerp meeting (October 2012). With the second Delphi round the experts selected HSCL-25 as the best consensus for its effectiveness, reliability and ergonomics. Conclusion: The HSCL 25 is the best consensus tool for a depression diagnosis in adult patients in general practice setting. The best effective, reliable and ergonomic tool Will enable the selection of homogenous populations across Europe for FPDM.

depression; diagnostic tool; family medicine

European Journal of General Practice, 2013 ; 19:162-184