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. 2012 Sep;9(3):149-60.

Investigating the Use of NICE Guidelines and IAPT Services in the Treatment of Depression

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Free PMC article

Investigating the Use of NICE Guidelines and IAPT Services in the Treatment of Depression

Alex Gyani et al. Ment Health Fam Med. .
Free PMC article

Abstract

Background There is evidence that the National Institute for Health and Clinical Excellence (NICE) guidelines for mental health disorders are used to varying degrees in primary care. A lack of access to cognitive-behavioural therapy (CBT) has been found to be a barrier to their implementation. The Improving Access to Psychological Therapies (IAPT) initiative was created in 2007 to increase the availability of NICE-recommended psychological treatments for depression and anxiety disorders within the National Health Service in England. Aim This study aims to investigate whether general practitioners (GPs) who have access to IAPT services and use NICE guidelines are more likely to use NICE concordant treatments for depression than those who do not. Depression was chosen as it is the most common mental health problem facing primary care physicians. Method Questionnaires were sent to 830 GPs in southeast England and six GPs were interviewed. The response rate to the questionnaires was 27% (n = 222). Results Ninety-five per cent of GPs were aware of the NICE guidelines for depression, and 76% had read them. Concordance with the guidelines was significantly higher when GPs had access to a local IAPT service or had read the NICE guidelines. Conclusions The interviews revealed favourable views to IAPT services when used, although access to treatments was still a common barrier to the implementation of the NICE guidelines for depression.

Keywords: clinical guidelines; depression; evidence-based treatments.

Figures

Figure 1
Figure 1
The stepped care model (reprinted with permission from NICE, 2009)
Figure 2
Figure 2
Treatments normally prescribed when managing first episode of depression by severity of depression. CBT, cognitive–behavioural therapy; ECT, electroconvulsive therapy; TMS, transcranial magnetic stimulation
Figure 3
Figure 3
The effect of access to IAPT and reading the NICE guidelines on NICE concordance

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