Primary care physicians' evaluation and treatment of depression: Results of an experimental study using video vignettes

Steven A. Epstein, Lisa M. Hooper, Kevin P. Weinfurt, Venita DePuy, Lisa A. Cooper, William G. Harless, Cynthia M. Tracy

Research output: Contribution to journalArticlepeer-review

Abstract

Little is known about how patient and primary care physician characteristics are associated with quality of depression care. The authors conducted structured interviews of 404 randomly selected primary care physicians after their interaction with CD-ROM vignettes of actors portraying depressed patients. Vignettes varied along the dimensions of medical comorbidity, attributions regarding the cause of depression, style, race/ethnicity, and gender. Results show that physicians showed wide variation in treatment decisions; for example, most did not inquire about suicidal ideation, and most did not state that they would inform the patient that there can be a delay before an antidepressant is therapeutic. Several physician characteristics were significantly associated with management decisions. Notably, physician age was inversely correlated with a number of quality-of-care measures. In conclusion, quality of care varies among primary care physicians and appears to be associated with physician characteristics to a greater extent than patient characteristics.

Original languageEnglish (US)
Pages (from-to)674-695
Number of pages22
JournalMedical Care Research and Review
Volume65
Issue number6
DOIs
StatePublished - Dec 2008

Keywords

  • Depression
  • Physician decision making
  • Primary care
  • Standardized patients

ASJC Scopus subject areas

  • Health Policy

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