GENERAL-PRACTITIONER DIAGNOSIS OF DEPRESSION AND DEMENTIA IN THE ELDERLY - CAN ACADEMIC DETAILING MAKE A DIFFERENCE

The objective was to improve the ability of general practitioners (GPs ) to diagnose depression and dementia compared with standard screening measures. The setting was a retirement village on the outskirts of Sy dney, Australia. The study used a prepost design with a 6 month follow -up. The intervention involved a visit to the GP by an academic detail er who spent 15 minutes discussing the diagnosis of depression and dem entia. Ratings of depression and dementia on two occasions by GPs, and by independent interviews were made using the Geriatric Depression Sc ale, Mini-mental State Examination and Canberra Interview for the Elde rly. In the case of depression, the level of agreement (Kappa) between the GPs and all instruments increased significantly by a factor of be tween 2.3 and 3.3. The doctors did not significantly improve in their agreement with the instruments on the diagnosis of dementia. An academ ic detailing approach to improving GPs' abilities in the diagnosis of depression can be effective. A controlled trial would be justified to confirm this finding.