Effects of an educational outreach campaign (IMPACT) on depression management delivered to general practitioners in one primary care trust
Abstract:Objective: An educational outreach initiative with general practitioners (GPs) within Walsall, led by pharmacists and aimed at delivering evidence-based guidance on stepped care management of clinical depression.
Methods: Standardised educational material was produced with key messages and contributions by experts on prescribing principles and management of clinical depression based on NICE guidance. The primary care pharmacists together with a psychiatrist or other professional delivered the training through initial face-to-face meetings with GP practices and carrying out follow-up visits.
Evaluation: Analysis of prescribing data (PACT) on antidepressants, which included prescribing of defined daily doses (DDD) and net ingredient cost (NIC) of commonly prescribed antidepressants for the whole of Walsall teaching Primary Care Trust (tPCT) and comparison with prescribing data for the West Midlands and for England during the period June 2000 to June 2006.
Results: The use of Fluoxetine increased slightly and the prescribing of Dosulepin continued to fall. The prescribing of Escitalopram, which had steadily increased prior to the launch of campaign, showed decline, resulting in savings of over £50K in the year 2005 to 2006. This was in comparison to a relative increase in the prescribing for Escitalopram for the same time period in the West Midlands and nationally. Prescribing of Dosulepin continued to fall. The total cost of prescribing for the four antidepressants fell and theses changes were sustained over the following year.
Conclusions: The educational outreach campaign successfully influenced prescribing behaviour in terms of adhering to NICE guidance and cost-effective prescribing, and also facilitated improved communication among clinicians at the primary–secondary care interface.
Document Type: Research Article
Affiliations: 1: Head of Medicines Management, Walsall teaching Primary Care Trust, Jubilee House, Bloxwich Lane, Walsall, UK 2: Consultant in Adult Psychiatry, Dudley and Walsall Mental Health Partnership NHS Trust, Dorothy Pattison Hospital, Walsall WS2 9XH, UK;, Email: firstname.lastname@example.org
Publication date: September 1, 2009