LATE-LIFE DEPRESSION IN PRIMARY-CARE - HOW WELL ARE WE DOING

OBJECTIVE: To discover primary care physicians' attitudes toward their abilities to detect and treat depression in the elderly. DESIGN: A se lf-administered questionnaire sent to 1,000 primary care physicians in the state of Michigan. SETTING: The survey was sent to physicians who practice general internal medicine or family medicine. PARTICIPANTS: The questionnaire was sent to 500 MD and 500 DO physicians: equal repr esentation was given to general internal medicine and family medicine, Of all 1,000 physicians, 60% (n = 604) responded, 51% (n = 309) were MD's, 48% (n = 295) were DO's, 41% (n = 245) were general internists, and 59% (n = 359) were family medicine physicians. MEASUREMENTS AND MA IN RESULTS: Despite positive attitudes about their skills for detectin g and treating depression in the elderly, only one quarter of the resp ondents routinely used a screening tool in practice, Forty-one percent of all physicians were not aware of depression practice guidelines, F amily physicians were more confident about their treatment skills than were general internists (85% vs 50%; chi(2) = 11.42, p less than or e qual to .003). Male physicians more often endorsed pharmacologic treat ment, while female physicians more frequently used counseling and exer cise techniques to treat depressed older patients, Half of all physici ans felt knowledgeable about community resources to treat older depres sed patients. CONCLUSIONS: This survey identified several perceived ne eds for future targeted interventions: (1) additional Agency for Healt h Care Policy and Research guideline exposure for all primary care phy sicians, (2) targeted counseling skip intervention for male physicians and medication management for female physicians, and (3) additional c ontinuing medical education intervention for practicing general intern ists, Further research is needed to correlate physician attitudes with ensuing behaviors to fully appreciate the nature of late-life depress ion treatment within the primary care arena.