Patients' experiences of receiving collaborative care for the treatment of depression in the UK: a qualitative investigation

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Abstract:

Objective: We explored the experiences of patients who received treatment for depression during a 'phase II' platform trial of collaborative care in the UK.

Method: Semi-structured interviews were used to obtain information from 13 patients receiving collaborative care. Patients from a range of general practitioner (GP) practices within the trial were purposively sampled. The constant comparative approach within a framework analysis was used to identify emerging concepts and key themes.

Results: Three distinct themes in people's experience of collaborative care were identified: (1) the process of collaborative care; (2) the content of collaborative care; and (3) staying well. These themes were set against a backdrop in which patients described how they had been struggling with low mood. Our central therapeutic ingredients of information giving, behavioural activation and medication management were supported by patients. Patients expressed reservations about the rigid inflexibility of telephone-based treatment.

Conclusions: While most of the protocol elements were supported by patients, we have been able to amend our protocol to allow for greater delivery flexibility and more attention to the therapeutic alliance and relapse prevention. We are now testing this in a multicentre randomised controlled trial.

Keywords: COLLABORATIVE CARE; DEPRESSION IN PRIMARY CARE; LIVED EXPERIENCE; QUALITATIVE RESEARCH

Document Type: Research Article

Affiliations: 1: Department of Health Sciences, University of York, UK 2: Professor of Primary Care Psychiatry, University of Manchester, UK 3: Department of Nursing, Midwifery and Social Work, University of Manchester, UK

Publication date: June 1, 2008

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