Depressive symptoms at old age : proactive management in general practice

Leiden Repository

Depressive symptoms at old age : proactive management in general practice

Title: Depressive symptoms at old age : proactive management in general practice
Author: Weele, Gerdina Marion (Gerda) van der
Publisher: Department of Public Health and Primary Care, Faculty of Medicine, Leiden University Medical Center (LUMC), Leiden University
Issue Date: 2011-12-07
Keywords: Depressive symptoms
Elderly
Screening
GDS-15
Intervention uptake
RCT
Pragmatic study
General practice
Abstract: This thesis describes the PROMODE-study, which investigated in a pragmatic way whether a pro-active approach in primary care by screening for depressive symptoms, followed by an intervention offer to persons of 75 years and over who screened positive, is (cost)effective to detect and relieve suffering from depressive symptoms at old age. We compared two screening methods regarding yield and costs. Furthermore, we found that scores of the 15-item Geriatric Depression Scale were higher when this screening questionnaire was self-administered than when interviewer-administered. In our intervention study, a cluster-randomised controlled trial, we found that the stepped-care intervention program was not (cost)effective compared with usual care in general practice, possibly due to a low uptake of the offered course being the main part of the intervention. In a qualitative study we explored the limiting and motivating factors for accepting course participation. This revealed that most persons were not (yet) prepared to accept the unsolicited intervention offer, although perceived needs to relieve depressive symptoms seemed to largely match the elements of the course. It is discussed that a more selective approach, aimed at high risk-groups and focussing on need for and readiness to accept help, might increase efficiency of a combined screening-intervention program.
Description: Promotores: J. Gussekloo, R.C. van der Mast, W.J.J. Assendelft, Co-Promotor: M.W.M. de Waal
With Summary in Dutch
Faculty: LUMC
Citation: Weele, G.M. van der, 2011, Doctoral Thesis, Leiden University
ISBN: 9789461691309
Sponsor: ZonMw (programma Doelmatigheid) en Rivierduinen
Handle: http://hdl.handle.net/1887/18193
 

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application/pdf Title Pages_Contents 97.36Kb View/Open
application/pdf Chapter 1 128.7Kb View/Open
application/pdf Chapter 2 205.8Kb Under embargo Full text at publisher site
application/pdf Chapter 3 263.4Kb Under embargo Full text at publisher site
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application/pdf Chapter 8 188.2Kb View/Open
application/pdf Summary in English 115.9Kb View/Open
application/pdf Summary in Dutch 119.9Kb View/Open
application/pdf Acknowledgements 65.48Kb View/Open
application/pdf Curriculum Vitae 77.91Kb View/Open
application/pdf Propositions 11.87Kb View/Open

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