Quality Measures Database

Changes to or the characteristics of the health status of an individual which may lead to distress, interference with daily activities, or contact with health services. This also includes symptom severity.
Additional Domain(s) : Accessibility, Quality and Safety

Meta analysis of studies was performed. Unselected feedback did not improve the recognition of depression (RR=0.96, 95% CI=0.83 to 1.10). High-risk feedback was shown to be effective in increasing the rate of recognition of depression (RR=2.66, 95% CI=1.78 to 3.96). This intervention increased the rate of detection of depression by 27% (95% CI=14% to 40%). Nine studies investigated the effect of the feedback of questionnaire results on the rate of intervention for emotional problems – such as referral to outside agencies and the commencement of treatment for depression. All but two studies showed non-significant results. Eight studies examined the effect of routine questionnaires on the level of depression over time. No overall effect on depression was identified in seven of the eight studies. This study suggests that unrecognised depressive symptoms resolve over a twelve month period, irrespective of whether feedback was employed or not. Similarly, another study showed a lack of overall effect of GHQ feedback on subsequent GHQ scores.

Nine randomised and non-randomised controlled clinical trials conducted in non-specialist settings were identified. The routine feedback of the findings of these instruments had no impact on the recognition of depression or on longer term psychosocial functioning in any of the studies.

Gilbody S, Whitty P, Grimshaw J, Thomas R. Educational and organizational interventions to improve the management of depression in primary care: a systematic review. JAMA. 2003 Jun 18;289(23):3145-51. Review.
PMID: 12813120

I: Consistently higher quality studies specifically focused on primary mental health care.

• This measure should also reflect action and follow-up outcomes, not just the use of questionnaires.
• Customers do get fed up with questionnaires to be filled out, especially if in a very long term support program. We are human.
• * Routine and standardized testing is very labour intensive and requires data input, analyzing and reporting in order to be of much use - need to be sure of capacity to deliver on all areas before selecting the tool.

Ratings-based Rank Relevance 91 Actionability 56 Overall Importance 94		Stakeholder Rank Academics 76 Clinicians 94 Consumers 73 Decision Makers 84 �		Special Group Rank First Nations 78 Rural Areas 48 Federal Stakeholders 50
Regional Rank BC AB SK MB ON QC NB NS PE NL YT NT NU 69 47 99 115 96 88 58 97 149 65 31 39 37				Overall Rank        84