International Journal for Quality in Health Care Advance Access originally published online on October 31, 2005
International Journal for Quality in Health Care 2006 18(2):113-119; doi:10.1093/intqhc/mzi089
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Quality in Practice
Improving quality of care for depression: the German Action Programme for the implementation of evidence-based guidelines
1 Department of Psychiatry and Psychotherapy, Section of Clinical Epidemiology and Health Services Research, University of Freiburg, Freiburg, 2 Agency for Quality in Medicine, Berlin, 3 Department of Psychiatry and Psychotherapy, RWTH Aachen University, Aachen, 4 Department of Psychiatry and Psychotherapy, University of Düsseldorf, Düsseldorf, 5 Department of Psychiatry and Psychotherapy, University of Munich, Munich, and 6 Department of General Medicine, University of Freiburg, Freiburg, Germany
Issue. Depressive disorders are of great medical and political significance. The potential inherent in achieving better guideline orientation and a better collaboration between different types of care is clear. Throughout the 1990s, educational initiatives were started for implementing guidelines. Evidence-based guidelines on depression have been formulated in many countries.
Purpose. This article presents an action programme for structural, educational, and research-related measures to implement evidence-based care of depressive disorders in the German health system. The starting points of the programme are the ‘Guidelines Critical Appraisal Reports’ of the ‘Guideline Clearing House’ and measures from the ‘Competence Network on Depression and Suicidality’ (CNDS) funded by the Federal Ministry of Education and Research. The article gives an overview of the steps achieved as recommended by the Guidelines Critical Appraisal Reports and the ongoing transfer process into the German health care system.
Results. The action programme shows that comprehensive interventions to develop and introduce evidence-based guidelines for depression can achieve benefits in the care of depression, e.g. in recognition, management, and clinical outcome.
Conclusion. It was possible to implement the German Action Programme in selected care settings, and initial evaluation results suggest some improvements. The action programme provides preliminary work, materials, and results for developing a future ‘Disease Management Programme’ (DMP) for depression.
Keywords: depression, evidence-based guidelines, health care system, implementation, quality assurance
Address reprint requests to Professor Martin Härter, Department of Psychiatry and Psychotherapy, University of Freiburg, Hauptstrasse 5, D-79104 Freiburg. E-mail: martin_haerter{at}psyallg.ukl.uni-freiburg.de
Accepted for publication October 3, 2005.