Shifts in the care for patients presenting in primary care with anxiety; stepped collaborative care parameters from more than a decade.

摘要: Abstract Background The mental health burden on primary care is substantial and increasing. Anxiety a major contributor. Stepped collaborative (SCC) implemented worldwide to improve patient outcomes, but long term real-world evaluations of SCC do not exist. Using routinely used electronic medical records from more than decade, we investigated changes in anxiety prevalences, whether physicians made distinction between non-severe severe anxiety, these groups were referred treated differently, both non-pharmacologically pharmacologically. Methods Retrospective assessment parameters recorded by 54 general practitioners 2003 2014, the dynamic population 49,841–69,413 patients. Results Substantial shifts have occurred. prevalence symptoms doubled 0.9% disorders almost tripled 1.1%. Use ICPC codes seemed comprehensive use instruments support level differentiation increased 13% symptom 7% disorder patients 2014. Minimal interventions frequently, especially for (OR 21 [95% CI 5.1–85]). antidepressant prescription rates decreased significantly 0.5 0.4–0.8]) 0.6 0.4–0.8]). More psychologists psychiatrists. Conclusions We found that follow principles SCC. Future research should comprehensively assess range therapeutic options, tailored with all different severity levels.