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Care managers can be useful for patients with depression but their role must be clear: a qualitative study of GPs' experiences
Karolinska Inst, Div Family Med & Primary Care, Dept Neurobiol Care Sci & Soc, Alfred Nobels Alle 23, S-14152 Stockholm, Sweden;Stockholm Cty Council, Acad Primary Hlth Care Ctr, Stockholm, Sweden.
Univ Gothenburg, Sahlgrenska Acad, Inst Med, Primary Hlth Care,Dept Publ Hlth & Community Med, Gothenburg, Sweden.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
Dalarna Univ, Sch Educ Hlth & Social Studies, Falun, Sweden;Ctr Clin Res Dalarna, CKF, Falun, Sweden.
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2019 (English)In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 37, no 3, p. 273-282Article in journal (Refereed) Published
Abstract [en]

Objective: Explore general practitioners' (GPs') views on and experiences of working with care managers for patients treated for depression in primary care settings. Care managers are specially trained health care professionals, often specialist nurses, who coordinate care for patients with chronic diseases. Design: Qualitative content analysis of five focus-group discussions. Setting: Primary health care centers in the Region of Vastra Gotaland and Dalarna County, Sweden. Subjects: 29 GPs. Main outcome measures: GPs' views and experiences of care managers for patients with depression. Results: GPs expressed a broad variety of views and experiences. Care managers could ensure care quality while freeing GPs from case management by providing support for patients and security and relief for GPs and by coordinating patient care. GPs could also express concern about role overlap; specifically, that GPs are already care managers, that too many caregivers disrupt patient contact, and that the roles of care managers and psychotherapists seem to compete. GPs thought care managers should be assigned to patients who need them the most (e.g. patients with life difficulties or severe mental health problems). They also found that transition to a chronic care model required change, including alterations in the way GPs worked and changes that made depression treatment more like treatment for other chronic diseases. Conclusion: GPs have varied experiences of care managers. As a complementary part of the primary health care team, care managers can be useful for patients with depression, but team members' roles must be clear.

Place, publisher, year, edition, pages
TAYLOR & FRANCIS LTD , 2019. Vol. 37, no 3, p. 273-282
Keywords [en]
Primary care, family medicine, nursing interventions, coordinated care, psychiatry, patient care continuity, collaborative care
National Category
Health Care Service and Management, Health Policy and Services and Health Economy General Practice
Identifiers
URN: urn:nbn:se:uu:diva-393834DOI: 10.1080/02813432.2019.1639897ISI: 000482039500002PubMedID: 31286807OAI: oai:DiVA.org:uu-393834DiVA, id: diva2:1355360
Available from: 2019-09-27 Created: 2019-09-27 Last updated: 2019-09-27Bibliographically approved

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