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Ruths Sabine - One of the best experts on this subject based on the ideXlab platform.
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Trends in treatment for patients with depression in general practice in Norway, 2009–2015: nationwide registry-based cohort study (The Norwegian GP-DEP Study)
2021Co-Authors: Ruths Sabine, Haukenes Inger, Hetlevik Øystein, Smith-sivertsen Tone, Hjørleifsson Stefan, Hansen, Anneli Borge, Riiser Sharline, Meling, Heidi Marie Kirkeng, Baste ValborgAbstract:Background Depression is highly prevalent, but knowledge is scarce as to whether increased public awareness and strengthened government focus on mental health have changed how general practitioners (GPs) help their depressed patients. This study aimed to examine national time trends in GP depression care and whether trends varied regarding patient gender, age, and comorbidity. Methods Nationwide registry-based cohort study, Norway. The study population comprised all residents aged 20 years or older with new depression diagnoses recorded in general practice, 2009–2015. We linked reimbursement claims data from all consultations in general practice for depression with information on demographics and antidepressant medication. The outcome was type(s) of GP depression care during 12 months from the date of diagnosis: (long) consultation, Talking Therapy, antidepressant drug treatment, sickness absence certification, and referral to secondary mental health care. Covariates were patient gender, age, and comorbidity. The data are presented as frequencies and tested with generalized linear models. Results We included 365,947 new depression diagnoses. Mean patient age was 44 years (SD = 16), 61.9 % were women, 41.2 % had comorbidity. From 2009 to 2015, proportions of patients receiving Talking Therapy (42.3–63.4 %), long consultations (56.4–71.8 %), and referral to secondary care (16.6–21.6 %) increased, while those receiving drug treatment (31.3–25.9 %) and sick-listing (58.1–50 %) decreased. The trends were different for gender (women had a greater increase in Talking Therapy and a smaller decrease in sick-listing, compared to men), age (working-aged patients had a smaller increase in Talking Therapy, a greater increase in long consultations, and a smaller decrease in antidepressant drug use, compared to older patients) and comorbidity (patients with mental comorbidity had a smaller increase in Talking Therapy and a greater increase in long consultations, compared to those with no comorbidity and somatic comorbidity). Conclusions The observed time trends in GP depression care towards increased provision of psychological treatment and less drug treatment and sick-listing were in the desired direction according to Norwegian health care policy. However, the large and persistent differences in treatment rates between working-aged and older patients needs further investigation
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Trends in treatment for patients with depression in general practice in Norway, 2009–2015: nationwide registry-based cohort study (The Norwegian GP-DEP Study)
'Springer Science and Business Media LLC', 2021Co-Authors: Ruths Sabine, Haukenes Inger, Hetlevik Øystein, Smith-sivertsen Tone, Hjørleifsson Stefan, Hansen, Anneli Borge, Riiser Sharline, Meling, Heidi Marie Kirkeng, Baste ValborgAbstract:Background Depression is highly prevalent, but knowledge is scarce as to whether increased public awareness and strengthened government focus on mental health have changed how general practitioners (GPs) help their depressed patients. This study aimed to examine national time trends in GP depression care and whether trends varied regarding patient gender, age, and comorbidity. Methods Nationwide registry-based cohort study, Norway. The study population comprised all residents aged 20 years or older with new depression diagnoses recorded in general practice, 2009–2015. We linked reimbursement claims data from all consultations in general practice for depression with information on demographics and antidepressant medication. The outcome was type(s) of GP depression care during 12 months from the date of diagnosis: (long) consultation, Talking Therapy, antidepressant drug treatment, sickness absence certification, and referral to secondary mental health care. Covariates were patient gender, age, and comorbidity. The data are presented as frequencies and tested with generalized linear models. Results We included 365,947 new depression diagnoses. Mean patient age was 44 years (SD = 16), 61.9 % were women, 41.2 % had comorbidity. From 2009 to 2015, proportions of patients receiving Talking Therapy (42.3–63.4 %), long consultations (56.4–71.8 %), and referral to secondary care (16.6–21.6 %) increased, while those receiving drug treatment (31.3–25.9 %) and sick-listing (58.1–50 %) decreased. The trends were different for gender (women had a greater increase in Talking Therapy and a smaller decrease in sick-listing, compared to men), age (working-aged patients had a smaller increase in Talking Therapy, a greater increase in long consultations, and a smaller decrease in antidepressant drug use, compared to older patients) and comorbidity (patients with mental comorbidity had a smaller increase in Talking Therapy and a greater increase in long consultations, compared to those with no comorbidity and somatic comorbidity). Conclusions The observed time trends in GP depression care towards increased provision of psychological treatment and less drug treatment and sick-listing were in the desired direction according to Norwegian health care policy. However, the large and persistent differences in treatment rates between working-aged and older patients needs further investigation.publishedVersio
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Variation in general practitioners’ depression care following certification of sickness absence: a registry-based cohort study
'Oxford University Press (OUP)', 2020Co-Authors: Riiser Sharline, Haukenes Inger, Hetlevik Øystein, Smith-sivertsen Tone, Baste Valborg, Ruths SabineAbstract:Background Depression is more prevalent among women and people with low socio-economic status. Uncertainties exist about how general practitioner (GP) depression care varies with patients’ social position. Objective To investigate associations between patients’ gender and educational status combined and GP depression care following certification of sickness absence. Methods Nationwide registry-based cohort study, Norway, 2012–14. Reimbursement claims data from all consultations in general practice for depression were linked with information on socio-demographic data, social security benefits and depression medication. The study population comprised all individuals aged 25–66 years with taxable income, sick-listed with a new depression diagnosis in general practice in 2013 (n = 8857). We defined six intersectional groups by combining educational level and gender. The outcome was type of GP depression care during sick leave: follow-up consultation(s), Talking Therapy, medication and referral to secondary care. Associations between intersectional groups and outcome were estimated using generalized linear models. Results Among long-term absentees (17 days or more), highly educated women were less likely to receive medication compared to all other patient groups [relative risk (RR) ranging from 1.17 (95% confidence interval 1.03–1.33) to 1.49 (1.29–1.72)] and more likely to receive Talking Therapy than women with medium [RR = 0.90 (0.84–0.98)] or low [RR = 0.91 (0.85–0.98)] education. Conclusions Our findings suggest that GPs provide equitable depression care regarding consultations and referrals for all intersectional groups but differential drug treatment and Talking Therapy for highly educated women. GPs need to be aware of these variations to provide personalized care and to prevent reproducing inequity.publishedVersio
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Variation in general practitioners’ depression care following certification of sickness absence: a registry-based cohort study
2020Co-Authors: Riiser Sharline, Haukenes Inger, Hetlevik Øystein, Smith-sivertsen Tone, Baste Valborg, Ruths SabineAbstract:Background Depression is more prevalent among women and people with low socio-economic status. Uncertainties exist about how general practitioner (GP) depression care varies with patients’ social position. Objective To investigate associations between patients’ gender and educational status combined and GP depression care following certification of sickness absence. Methods Nationwide registry-based cohort study, Norway, 2012–14. Reimbursement claims data from all consultations in general practice for depression were linked with information on socio-demographic data, social security benefits and depression medication. The study population comprised all individuals aged 25–66 years with taxable income, sick-listed with a new depression diagnosis in general practice in 2013 (n = 8857). We defined six intersectional groups by combining educational level and gender. The outcome was type of GP depression care during sick leave: follow-up consultation(s), Talking Therapy, medication and referral to secondary care. Associations between intersectional groups and outcome were estimated using generalized linear models. Results Among long-term absentees (17 days or more), highly educated women were less likely to receive medication compared to all other patient groups [relative risk (RR) ranging from 1.17 (95% confidence interval 1.03–1.33) to 1.49 (1.29–1.72)] and more likely to receive Talking Therapy than women with medium [RR = 0.90 (0.84–0.98)] or low [RR = 0.91 (0.85–0.98)] education. Conclusions Our findings suggest that GPs provide equitable depression care regarding consultations and referrals for all intersectional groups but differential drug treatment and Talking Therapy for highly educated women. GPs need to be aware of these variations to provide personalized care and to prevent reproducing inequity
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Patient-reported depression treatment and future treatment preferences: an observational study in general practice
'Oxford University Press (OUP)', 2020Co-Authors: Hetlevik Øystein, Hjørleifsson Stefan, Garre-fivelsdal, Gina Dorothea, Bjorvatn Bjørn, Ruths SabineAbstract:Under embargo until: 2020-06-19Background: Depression is prevalent in general practice, but few studies have explored patient-reported depression care. Aim: To investigate patient-reported treatment received for depression and future treatment preferences among adult patients visiting their GP, and to evaluate the associations with sex, age and educational level. Design and Setting: A cross-sectional survey was conducted in general practices in Norway from 2016 to 2017. Methods: Altogether, 2335 consecutive patients (response rate, 89.2%) in the GPs’ waiting rooms answered a questionnaire about their received depression treatment and treatment preferences in case of future depression. Results: The study population (N = 2239) had a mean age of 48.6 ± 17.7 years (range 18–91), 60.1% were women. Of the 770 patients reporting to have received depression treatment, 39.1% were treated exclusively by their GP while 52.5% also were referred to a psychologist/psychiatrist. Older age was positively associated with medication and negatively associated with referrals to psychologist/psychiatrist. People with high education had lower odds for receiving medication (odds ratios [OR], 0.49; 95% confidence intervals [CI]: 0.30–0.80) compared to those with low education. If future depression, 81.6% of the respondents would discuss this with their GP, 60.9% would prefer Talking Therapy with their GP, 22.5% medication, and 52.9% referral to psychologist or psychiatrist. Conclusion: One-third of the patients attending their GPs had consulted with them at some time concerning depression the case of future depression, most patients preferred Talking Therapy with the GP. This finding warrants increased research focus on the GP’s role in depression care.acceptedVersio
Baste Valborg - One of the best experts on this subject based on the ideXlab platform.
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Trends in treatment for patients with depression in general practice in Norway, 2009–2015: nationwide registry-based cohort study (The Norwegian GP-DEP Study)
2021Co-Authors: Ruths Sabine, Haukenes Inger, Hetlevik Øystein, Smith-sivertsen Tone, Hjørleifsson Stefan, Hansen, Anneli Borge, Riiser Sharline, Meling, Heidi Marie Kirkeng, Baste ValborgAbstract:Background Depression is highly prevalent, but knowledge is scarce as to whether increased public awareness and strengthened government focus on mental health have changed how general practitioners (GPs) help their depressed patients. This study aimed to examine national time trends in GP depression care and whether trends varied regarding patient gender, age, and comorbidity. Methods Nationwide registry-based cohort study, Norway. The study population comprised all residents aged 20 years or older with new depression diagnoses recorded in general practice, 2009–2015. We linked reimbursement claims data from all consultations in general practice for depression with information on demographics and antidepressant medication. The outcome was type(s) of GP depression care during 12 months from the date of diagnosis: (long) consultation, Talking Therapy, antidepressant drug treatment, sickness absence certification, and referral to secondary mental health care. Covariates were patient gender, age, and comorbidity. The data are presented as frequencies and tested with generalized linear models. Results We included 365,947 new depression diagnoses. Mean patient age was 44 years (SD = 16), 61.9 % were women, 41.2 % had comorbidity. From 2009 to 2015, proportions of patients receiving Talking Therapy (42.3–63.4 %), long consultations (56.4–71.8 %), and referral to secondary care (16.6–21.6 %) increased, while those receiving drug treatment (31.3–25.9 %) and sick-listing (58.1–50 %) decreased. The trends were different for gender (women had a greater increase in Talking Therapy and a smaller decrease in sick-listing, compared to men), age (working-aged patients had a smaller increase in Talking Therapy, a greater increase in long consultations, and a smaller decrease in antidepressant drug use, compared to older patients) and comorbidity (patients with mental comorbidity had a smaller increase in Talking Therapy and a greater increase in long consultations, compared to those with no comorbidity and somatic comorbidity). Conclusions The observed time trends in GP depression care towards increased provision of psychological treatment and less drug treatment and sick-listing were in the desired direction according to Norwegian health care policy. However, the large and persistent differences in treatment rates between working-aged and older patients needs further investigation
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Trends in treatment for patients with depression in general practice in Norway, 2009–2015: nationwide registry-based cohort study (The Norwegian GP-DEP Study)
'Springer Science and Business Media LLC', 2021Co-Authors: Ruths Sabine, Haukenes Inger, Hetlevik Øystein, Smith-sivertsen Tone, Hjørleifsson Stefan, Hansen, Anneli Borge, Riiser Sharline, Meling, Heidi Marie Kirkeng, Baste ValborgAbstract:Background Depression is highly prevalent, but knowledge is scarce as to whether increased public awareness and strengthened government focus on mental health have changed how general practitioners (GPs) help their depressed patients. This study aimed to examine national time trends in GP depression care and whether trends varied regarding patient gender, age, and comorbidity. Methods Nationwide registry-based cohort study, Norway. The study population comprised all residents aged 20 years or older with new depression diagnoses recorded in general practice, 2009–2015. We linked reimbursement claims data from all consultations in general practice for depression with information on demographics and antidepressant medication. The outcome was type(s) of GP depression care during 12 months from the date of diagnosis: (long) consultation, Talking Therapy, antidepressant drug treatment, sickness absence certification, and referral to secondary mental health care. Covariates were patient gender, age, and comorbidity. The data are presented as frequencies and tested with generalized linear models. Results We included 365,947 new depression diagnoses. Mean patient age was 44 years (SD = 16), 61.9 % were women, 41.2 % had comorbidity. From 2009 to 2015, proportions of patients receiving Talking Therapy (42.3–63.4 %), long consultations (56.4–71.8 %), and referral to secondary care (16.6–21.6 %) increased, while those receiving drug treatment (31.3–25.9 %) and sick-listing (58.1–50 %) decreased. The trends were different for gender (women had a greater increase in Talking Therapy and a smaller decrease in sick-listing, compared to men), age (working-aged patients had a smaller increase in Talking Therapy, a greater increase in long consultations, and a smaller decrease in antidepressant drug use, compared to older patients) and comorbidity (patients with mental comorbidity had a smaller increase in Talking Therapy and a greater increase in long consultations, compared to those with no comorbidity and somatic comorbidity). Conclusions The observed time trends in GP depression care towards increased provision of psychological treatment and less drug treatment and sick-listing were in the desired direction according to Norwegian health care policy. However, the large and persistent differences in treatment rates between working-aged and older patients needs further investigation.publishedVersio
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Variation in general practitioners’ depression care following certification of sickness absence: a registry-based cohort study
'Oxford University Press (OUP)', 2020Co-Authors: Riiser Sharline, Haukenes Inger, Hetlevik Øystein, Smith-sivertsen Tone, Baste Valborg, Ruths SabineAbstract:Background Depression is more prevalent among women and people with low socio-economic status. Uncertainties exist about how general practitioner (GP) depression care varies with patients’ social position. Objective To investigate associations between patients’ gender and educational status combined and GP depression care following certification of sickness absence. Methods Nationwide registry-based cohort study, Norway, 2012–14. Reimbursement claims data from all consultations in general practice for depression were linked with information on socio-demographic data, social security benefits and depression medication. The study population comprised all individuals aged 25–66 years with taxable income, sick-listed with a new depression diagnosis in general practice in 2013 (n = 8857). We defined six intersectional groups by combining educational level and gender. The outcome was type of GP depression care during sick leave: follow-up consultation(s), Talking Therapy, medication and referral to secondary care. Associations between intersectional groups and outcome were estimated using generalized linear models. Results Among long-term absentees (17 days or more), highly educated women were less likely to receive medication compared to all other patient groups [relative risk (RR) ranging from 1.17 (95% confidence interval 1.03–1.33) to 1.49 (1.29–1.72)] and more likely to receive Talking Therapy than women with medium [RR = 0.90 (0.84–0.98)] or low [RR = 0.91 (0.85–0.98)] education. Conclusions Our findings suggest that GPs provide equitable depression care regarding consultations and referrals for all intersectional groups but differential drug treatment and Talking Therapy for highly educated women. GPs need to be aware of these variations to provide personalized care and to prevent reproducing inequity.publishedVersio
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Variation in general practitioners’ depression care following certification of sickness absence: a registry-based cohort study
2020Co-Authors: Riiser Sharline, Haukenes Inger, Hetlevik Øystein, Smith-sivertsen Tone, Baste Valborg, Ruths SabineAbstract:Background Depression is more prevalent among women and people with low socio-economic status. Uncertainties exist about how general practitioner (GP) depression care varies with patients’ social position. Objective To investigate associations between patients’ gender and educational status combined and GP depression care following certification of sickness absence. Methods Nationwide registry-based cohort study, Norway, 2012–14. Reimbursement claims data from all consultations in general practice for depression were linked with information on socio-demographic data, social security benefits and depression medication. The study population comprised all individuals aged 25–66 years with taxable income, sick-listed with a new depression diagnosis in general practice in 2013 (n = 8857). We defined six intersectional groups by combining educational level and gender. The outcome was type of GP depression care during sick leave: follow-up consultation(s), Talking Therapy, medication and referral to secondary care. Associations between intersectional groups and outcome were estimated using generalized linear models. Results Among long-term absentees (17 days or more), highly educated women were less likely to receive medication compared to all other patient groups [relative risk (RR) ranging from 1.17 (95% confidence interval 1.03–1.33) to 1.49 (1.29–1.72)] and more likely to receive Talking Therapy than women with medium [RR = 0.90 (0.84–0.98)] or low [RR = 0.91 (0.85–0.98)] education. Conclusions Our findings suggest that GPs provide equitable depression care regarding consultations and referrals for all intersectional groups but differential drug treatment and Talking Therapy for highly educated women. GPs need to be aware of these variations to provide personalized care and to prevent reproducing inequity
Hetlevik Øystein - One of the best experts on this subject based on the ideXlab platform.
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Trends in treatment for patients with depression in general practice in Norway, 2009–2015: nationwide registry-based cohort study (The Norwegian GP-DEP Study)
2021Co-Authors: Ruths Sabine, Haukenes Inger, Hetlevik Øystein, Smith-sivertsen Tone, Hjørleifsson Stefan, Hansen, Anneli Borge, Riiser Sharline, Meling, Heidi Marie Kirkeng, Baste ValborgAbstract:Background Depression is highly prevalent, but knowledge is scarce as to whether increased public awareness and strengthened government focus on mental health have changed how general practitioners (GPs) help their depressed patients. This study aimed to examine national time trends in GP depression care and whether trends varied regarding patient gender, age, and comorbidity. Methods Nationwide registry-based cohort study, Norway. The study population comprised all residents aged 20 years or older with new depression diagnoses recorded in general practice, 2009–2015. We linked reimbursement claims data from all consultations in general practice for depression with information on demographics and antidepressant medication. The outcome was type(s) of GP depression care during 12 months from the date of diagnosis: (long) consultation, Talking Therapy, antidepressant drug treatment, sickness absence certification, and referral to secondary mental health care. Covariates were patient gender, age, and comorbidity. The data are presented as frequencies and tested with generalized linear models. Results We included 365,947 new depression diagnoses. Mean patient age was 44 years (SD = 16), 61.9 % were women, 41.2 % had comorbidity. From 2009 to 2015, proportions of patients receiving Talking Therapy (42.3–63.4 %), long consultations (56.4–71.8 %), and referral to secondary care (16.6–21.6 %) increased, while those receiving drug treatment (31.3–25.9 %) and sick-listing (58.1–50 %) decreased. The trends were different for gender (women had a greater increase in Talking Therapy and a smaller decrease in sick-listing, compared to men), age (working-aged patients had a smaller increase in Talking Therapy, a greater increase in long consultations, and a smaller decrease in antidepressant drug use, compared to older patients) and comorbidity (patients with mental comorbidity had a smaller increase in Talking Therapy and a greater increase in long consultations, compared to those with no comorbidity and somatic comorbidity). Conclusions The observed time trends in GP depression care towards increased provision of psychological treatment and less drug treatment and sick-listing were in the desired direction according to Norwegian health care policy. However, the large and persistent differences in treatment rates between working-aged and older patients needs further investigation
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Trends in treatment for patients with depression in general practice in Norway, 2009–2015: nationwide registry-based cohort study (The Norwegian GP-DEP Study)
'Springer Science and Business Media LLC', 2021Co-Authors: Ruths Sabine, Haukenes Inger, Hetlevik Øystein, Smith-sivertsen Tone, Hjørleifsson Stefan, Hansen, Anneli Borge, Riiser Sharline, Meling, Heidi Marie Kirkeng, Baste ValborgAbstract:Background Depression is highly prevalent, but knowledge is scarce as to whether increased public awareness and strengthened government focus on mental health have changed how general practitioners (GPs) help their depressed patients. This study aimed to examine national time trends in GP depression care and whether trends varied regarding patient gender, age, and comorbidity. Methods Nationwide registry-based cohort study, Norway. The study population comprised all residents aged 20 years or older with new depression diagnoses recorded in general practice, 2009–2015. We linked reimbursement claims data from all consultations in general practice for depression with information on demographics and antidepressant medication. The outcome was type(s) of GP depression care during 12 months from the date of diagnosis: (long) consultation, Talking Therapy, antidepressant drug treatment, sickness absence certification, and referral to secondary mental health care. Covariates were patient gender, age, and comorbidity. The data are presented as frequencies and tested with generalized linear models. Results We included 365,947 new depression diagnoses. Mean patient age was 44 years (SD = 16), 61.9 % were women, 41.2 % had comorbidity. From 2009 to 2015, proportions of patients receiving Talking Therapy (42.3–63.4 %), long consultations (56.4–71.8 %), and referral to secondary care (16.6–21.6 %) increased, while those receiving drug treatment (31.3–25.9 %) and sick-listing (58.1–50 %) decreased. The trends were different for gender (women had a greater increase in Talking Therapy and a smaller decrease in sick-listing, compared to men), age (working-aged patients had a smaller increase in Talking Therapy, a greater increase in long consultations, and a smaller decrease in antidepressant drug use, compared to older patients) and comorbidity (patients with mental comorbidity had a smaller increase in Talking Therapy and a greater increase in long consultations, compared to those with no comorbidity and somatic comorbidity). Conclusions The observed time trends in GP depression care towards increased provision of psychological treatment and less drug treatment and sick-listing were in the desired direction according to Norwegian health care policy. However, the large and persistent differences in treatment rates between working-aged and older patients needs further investigation.publishedVersio
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Variation in general practitioners’ depression care following certification of sickness absence: a registry-based cohort study
'Oxford University Press (OUP)', 2020Co-Authors: Riiser Sharline, Haukenes Inger, Hetlevik Øystein, Smith-sivertsen Tone, Baste Valborg, Ruths SabineAbstract:Background Depression is more prevalent among women and people with low socio-economic status. Uncertainties exist about how general practitioner (GP) depression care varies with patients’ social position. Objective To investigate associations between patients’ gender and educational status combined and GP depression care following certification of sickness absence. Methods Nationwide registry-based cohort study, Norway, 2012–14. Reimbursement claims data from all consultations in general practice for depression were linked with information on socio-demographic data, social security benefits and depression medication. The study population comprised all individuals aged 25–66 years with taxable income, sick-listed with a new depression diagnosis in general practice in 2013 (n = 8857). We defined six intersectional groups by combining educational level and gender. The outcome was type of GP depression care during sick leave: follow-up consultation(s), Talking Therapy, medication and referral to secondary care. Associations between intersectional groups and outcome were estimated using generalized linear models. Results Among long-term absentees (17 days or more), highly educated women were less likely to receive medication compared to all other patient groups [relative risk (RR) ranging from 1.17 (95% confidence interval 1.03–1.33) to 1.49 (1.29–1.72)] and more likely to receive Talking Therapy than women with medium [RR = 0.90 (0.84–0.98)] or low [RR = 0.91 (0.85–0.98)] education. Conclusions Our findings suggest that GPs provide equitable depression care regarding consultations and referrals for all intersectional groups but differential drug treatment and Talking Therapy for highly educated women. GPs need to be aware of these variations to provide personalized care and to prevent reproducing inequity.publishedVersio
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Variation in general practitioners’ depression care following certification of sickness absence: a registry-based cohort study
2020Co-Authors: Riiser Sharline, Haukenes Inger, Hetlevik Øystein, Smith-sivertsen Tone, Baste Valborg, Ruths SabineAbstract:Background Depression is more prevalent among women and people with low socio-economic status. Uncertainties exist about how general practitioner (GP) depression care varies with patients’ social position. Objective To investigate associations between patients’ gender and educational status combined and GP depression care following certification of sickness absence. Methods Nationwide registry-based cohort study, Norway, 2012–14. Reimbursement claims data from all consultations in general practice for depression were linked with information on socio-demographic data, social security benefits and depression medication. The study population comprised all individuals aged 25–66 years with taxable income, sick-listed with a new depression diagnosis in general practice in 2013 (n = 8857). We defined six intersectional groups by combining educational level and gender. The outcome was type of GP depression care during sick leave: follow-up consultation(s), Talking Therapy, medication and referral to secondary care. Associations between intersectional groups and outcome were estimated using generalized linear models. Results Among long-term absentees (17 days or more), highly educated women were less likely to receive medication compared to all other patient groups [relative risk (RR) ranging from 1.17 (95% confidence interval 1.03–1.33) to 1.49 (1.29–1.72)] and more likely to receive Talking Therapy than women with medium [RR = 0.90 (0.84–0.98)] or low [RR = 0.91 (0.85–0.98)] education. Conclusions Our findings suggest that GPs provide equitable depression care regarding consultations and referrals for all intersectional groups but differential drug treatment and Talking Therapy for highly educated women. GPs need to be aware of these variations to provide personalized care and to prevent reproducing inequity
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Patient-reported depression treatment and future treatment preferences: an observational study in general practice
'Oxford University Press (OUP)', 2020Co-Authors: Hetlevik Øystein, Hjørleifsson Stefan, Garre-fivelsdal, Gina Dorothea, Bjorvatn Bjørn, Ruths SabineAbstract:Under embargo until: 2020-06-19Background: Depression is prevalent in general practice, but few studies have explored patient-reported depression care. Aim: To investigate patient-reported treatment received for depression and future treatment preferences among adult patients visiting their GP, and to evaluate the associations with sex, age and educational level. Design and Setting: A cross-sectional survey was conducted in general practices in Norway from 2016 to 2017. Methods: Altogether, 2335 consecutive patients (response rate, 89.2%) in the GPs’ waiting rooms answered a questionnaire about their received depression treatment and treatment preferences in case of future depression. Results: The study population (N = 2239) had a mean age of 48.6 ± 17.7 years (range 18–91), 60.1% were women. Of the 770 patients reporting to have received depression treatment, 39.1% were treated exclusively by their GP while 52.5% also were referred to a psychologist/psychiatrist. Older age was positively associated with medication and negatively associated with referrals to psychologist/psychiatrist. People with high education had lower odds for receiving medication (odds ratios [OR], 0.49; 95% confidence intervals [CI]: 0.30–0.80) compared to those with low education. If future depression, 81.6% of the respondents would discuss this with their GP, 60.9% would prefer Talking Therapy with their GP, 22.5% medication, and 52.9% referral to psychologist or psychiatrist. Conclusion: One-third of the patients attending their GPs had consulted with them at some time concerning depression the case of future depression, most patients preferred Talking Therapy with the GP. This finding warrants increased research focus on the GP’s role in depression care.acceptedVersio
Riiser Sharline - One of the best experts on this subject based on the ideXlab platform.
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Trends in treatment for patients with depression in general practice in Norway, 2009–2015: nationwide registry-based cohort study (The Norwegian GP-DEP Study)
2021Co-Authors: Ruths Sabine, Haukenes Inger, Hetlevik Øystein, Smith-sivertsen Tone, Hjørleifsson Stefan, Hansen, Anneli Borge, Riiser Sharline, Meling, Heidi Marie Kirkeng, Baste ValborgAbstract:Background Depression is highly prevalent, but knowledge is scarce as to whether increased public awareness and strengthened government focus on mental health have changed how general practitioners (GPs) help their depressed patients. This study aimed to examine national time trends in GP depression care and whether trends varied regarding patient gender, age, and comorbidity. Methods Nationwide registry-based cohort study, Norway. The study population comprised all residents aged 20 years or older with new depression diagnoses recorded in general practice, 2009–2015. We linked reimbursement claims data from all consultations in general practice for depression with information on demographics and antidepressant medication. The outcome was type(s) of GP depression care during 12 months from the date of diagnosis: (long) consultation, Talking Therapy, antidepressant drug treatment, sickness absence certification, and referral to secondary mental health care. Covariates were patient gender, age, and comorbidity. The data are presented as frequencies and tested with generalized linear models. Results We included 365,947 new depression diagnoses. Mean patient age was 44 years (SD = 16), 61.9 % were women, 41.2 % had comorbidity. From 2009 to 2015, proportions of patients receiving Talking Therapy (42.3–63.4 %), long consultations (56.4–71.8 %), and referral to secondary care (16.6–21.6 %) increased, while those receiving drug treatment (31.3–25.9 %) and sick-listing (58.1–50 %) decreased. The trends were different for gender (women had a greater increase in Talking Therapy and a smaller decrease in sick-listing, compared to men), age (working-aged patients had a smaller increase in Talking Therapy, a greater increase in long consultations, and a smaller decrease in antidepressant drug use, compared to older patients) and comorbidity (patients with mental comorbidity had a smaller increase in Talking Therapy and a greater increase in long consultations, compared to those with no comorbidity and somatic comorbidity). Conclusions The observed time trends in GP depression care towards increased provision of psychological treatment and less drug treatment and sick-listing were in the desired direction according to Norwegian health care policy. However, the large and persistent differences in treatment rates between working-aged and older patients needs further investigation
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Trends in treatment for patients with depression in general practice in Norway, 2009–2015: nationwide registry-based cohort study (The Norwegian GP-DEP Study)
'Springer Science and Business Media LLC', 2021Co-Authors: Ruths Sabine, Haukenes Inger, Hetlevik Øystein, Smith-sivertsen Tone, Hjørleifsson Stefan, Hansen, Anneli Borge, Riiser Sharline, Meling, Heidi Marie Kirkeng, Baste ValborgAbstract:Background Depression is highly prevalent, but knowledge is scarce as to whether increased public awareness and strengthened government focus on mental health have changed how general practitioners (GPs) help their depressed patients. This study aimed to examine national time trends in GP depression care and whether trends varied regarding patient gender, age, and comorbidity. Methods Nationwide registry-based cohort study, Norway. The study population comprised all residents aged 20 years or older with new depression diagnoses recorded in general practice, 2009–2015. We linked reimbursement claims data from all consultations in general practice for depression with information on demographics and antidepressant medication. The outcome was type(s) of GP depression care during 12 months from the date of diagnosis: (long) consultation, Talking Therapy, antidepressant drug treatment, sickness absence certification, and referral to secondary mental health care. Covariates were patient gender, age, and comorbidity. The data are presented as frequencies and tested with generalized linear models. Results We included 365,947 new depression diagnoses. Mean patient age was 44 years (SD = 16), 61.9 % were women, 41.2 % had comorbidity. From 2009 to 2015, proportions of patients receiving Talking Therapy (42.3–63.4 %), long consultations (56.4–71.8 %), and referral to secondary care (16.6–21.6 %) increased, while those receiving drug treatment (31.3–25.9 %) and sick-listing (58.1–50 %) decreased. The trends were different for gender (women had a greater increase in Talking Therapy and a smaller decrease in sick-listing, compared to men), age (working-aged patients had a smaller increase in Talking Therapy, a greater increase in long consultations, and a smaller decrease in antidepressant drug use, compared to older patients) and comorbidity (patients with mental comorbidity had a smaller increase in Talking Therapy and a greater increase in long consultations, compared to those with no comorbidity and somatic comorbidity). Conclusions The observed time trends in GP depression care towards increased provision of psychological treatment and less drug treatment and sick-listing were in the desired direction according to Norwegian health care policy. However, the large and persistent differences in treatment rates between working-aged and older patients needs further investigation.publishedVersio
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Variation in general practitioners’ depression care following certification of sickness absence: a registry-based cohort study
'Oxford University Press (OUP)', 2020Co-Authors: Riiser Sharline, Haukenes Inger, Hetlevik Øystein, Smith-sivertsen Tone, Baste Valborg, Ruths SabineAbstract:Background Depression is more prevalent among women and people with low socio-economic status. Uncertainties exist about how general practitioner (GP) depression care varies with patients’ social position. Objective To investigate associations between patients’ gender and educational status combined and GP depression care following certification of sickness absence. Methods Nationwide registry-based cohort study, Norway, 2012–14. Reimbursement claims data from all consultations in general practice for depression were linked with information on socio-demographic data, social security benefits and depression medication. The study population comprised all individuals aged 25–66 years with taxable income, sick-listed with a new depression diagnosis in general practice in 2013 (n = 8857). We defined six intersectional groups by combining educational level and gender. The outcome was type of GP depression care during sick leave: follow-up consultation(s), Talking Therapy, medication and referral to secondary care. Associations between intersectional groups and outcome were estimated using generalized linear models. Results Among long-term absentees (17 days or more), highly educated women were less likely to receive medication compared to all other patient groups [relative risk (RR) ranging from 1.17 (95% confidence interval 1.03–1.33) to 1.49 (1.29–1.72)] and more likely to receive Talking Therapy than women with medium [RR = 0.90 (0.84–0.98)] or low [RR = 0.91 (0.85–0.98)] education. Conclusions Our findings suggest that GPs provide equitable depression care regarding consultations and referrals for all intersectional groups but differential drug treatment and Talking Therapy for highly educated women. GPs need to be aware of these variations to provide personalized care and to prevent reproducing inequity.publishedVersio
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Variation in general practitioners’ depression care following certification of sickness absence: a registry-based cohort study
2020Co-Authors: Riiser Sharline, Haukenes Inger, Hetlevik Øystein, Smith-sivertsen Tone, Baste Valborg, Ruths SabineAbstract:Background Depression is more prevalent among women and people with low socio-economic status. Uncertainties exist about how general practitioner (GP) depression care varies with patients’ social position. Objective To investigate associations between patients’ gender and educational status combined and GP depression care following certification of sickness absence. Methods Nationwide registry-based cohort study, Norway, 2012–14. Reimbursement claims data from all consultations in general practice for depression were linked with information on socio-demographic data, social security benefits and depression medication. The study population comprised all individuals aged 25–66 years with taxable income, sick-listed with a new depression diagnosis in general practice in 2013 (n = 8857). We defined six intersectional groups by combining educational level and gender. The outcome was type of GP depression care during sick leave: follow-up consultation(s), Talking Therapy, medication and referral to secondary care. Associations between intersectional groups and outcome were estimated using generalized linear models. Results Among long-term absentees (17 days or more), highly educated women were less likely to receive medication compared to all other patient groups [relative risk (RR) ranging from 1.17 (95% confidence interval 1.03–1.33) to 1.49 (1.29–1.72)] and more likely to receive Talking Therapy than women with medium [RR = 0.90 (0.84–0.98)] or low [RR = 0.91 (0.85–0.98)] education. Conclusions Our findings suggest that GPs provide equitable depression care regarding consultations and referrals for all intersectional groups but differential drug treatment and Talking Therapy for highly educated women. GPs need to be aware of these variations to provide personalized care and to prevent reproducing inequity
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Trends in treatment for patients with depression in general practice in Norway, 2009–2015: nationwide registry-based cohort study (The Norwegian GP-DEP Study)
2021Co-Authors: Ruths Sabine, Haukenes Inger, Hetlevik Øystein, Smith-sivertsen Tone, Hjørleifsson Stefan, Hansen, Anneli Borge, Riiser Sharline, Meling, Heidi Marie Kirkeng, Baste ValborgAbstract:Background Depression is highly prevalent, but knowledge is scarce as to whether increased public awareness and strengthened government focus on mental health have changed how general practitioners (GPs) help their depressed patients. This study aimed to examine national time trends in GP depression care and whether trends varied regarding patient gender, age, and comorbidity. Methods Nationwide registry-based cohort study, Norway. The study population comprised all residents aged 20 years or older with new depression diagnoses recorded in general practice, 2009–2015. We linked reimbursement claims data from all consultations in general practice for depression with information on demographics and antidepressant medication. The outcome was type(s) of GP depression care during 12 months from the date of diagnosis: (long) consultation, Talking Therapy, antidepressant drug treatment, sickness absence certification, and referral to secondary mental health care. Covariates were patient gender, age, and comorbidity. The data are presented as frequencies and tested with generalized linear models. Results We included 365,947 new depression diagnoses. Mean patient age was 44 years (SD = 16), 61.9 % were women, 41.2 % had comorbidity. From 2009 to 2015, proportions of patients receiving Talking Therapy (42.3–63.4 %), long consultations (56.4–71.8 %), and referral to secondary care (16.6–21.6 %) increased, while those receiving drug treatment (31.3–25.9 %) and sick-listing (58.1–50 %) decreased. The trends were different for gender (women had a greater increase in Talking Therapy and a smaller decrease in sick-listing, compared to men), age (working-aged patients had a smaller increase in Talking Therapy, a greater increase in long consultations, and a smaller decrease in antidepressant drug use, compared to older patients) and comorbidity (patients with mental comorbidity had a smaller increase in Talking Therapy and a greater increase in long consultations, compared to those with no comorbidity and somatic comorbidity). Conclusions The observed time trends in GP depression care towards increased provision of psychological treatment and less drug treatment and sick-listing were in the desired direction according to Norwegian health care policy. However, the large and persistent differences in treatment rates between working-aged and older patients needs further investigation
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Trends in treatment for patients with depression in general practice in Norway, 2009–2015: nationwide registry-based cohort study (The Norwegian GP-DEP Study)
'Springer Science and Business Media LLC', 2021Co-Authors: Ruths Sabine, Haukenes Inger, Hetlevik Øystein, Smith-sivertsen Tone, Hjørleifsson Stefan, Hansen, Anneli Borge, Riiser Sharline, Meling, Heidi Marie Kirkeng, Baste ValborgAbstract:Background Depression is highly prevalent, but knowledge is scarce as to whether increased public awareness and strengthened government focus on mental health have changed how general practitioners (GPs) help their depressed patients. This study aimed to examine national time trends in GP depression care and whether trends varied regarding patient gender, age, and comorbidity. Methods Nationwide registry-based cohort study, Norway. The study population comprised all residents aged 20 years or older with new depression diagnoses recorded in general practice, 2009–2015. We linked reimbursement claims data from all consultations in general practice for depression with information on demographics and antidepressant medication. The outcome was type(s) of GP depression care during 12 months from the date of diagnosis: (long) consultation, Talking Therapy, antidepressant drug treatment, sickness absence certification, and referral to secondary mental health care. Covariates were patient gender, age, and comorbidity. The data are presented as frequencies and tested with generalized linear models. Results We included 365,947 new depression diagnoses. Mean patient age was 44 years (SD = 16), 61.9 % were women, 41.2 % had comorbidity. From 2009 to 2015, proportions of patients receiving Talking Therapy (42.3–63.4 %), long consultations (56.4–71.8 %), and referral to secondary care (16.6–21.6 %) increased, while those receiving drug treatment (31.3–25.9 %) and sick-listing (58.1–50 %) decreased. The trends were different for gender (women had a greater increase in Talking Therapy and a smaller decrease in sick-listing, compared to men), age (working-aged patients had a smaller increase in Talking Therapy, a greater increase in long consultations, and a smaller decrease in antidepressant drug use, compared to older patients) and comorbidity (patients with mental comorbidity had a smaller increase in Talking Therapy and a greater increase in long consultations, compared to those with no comorbidity and somatic comorbidity). Conclusions The observed time trends in GP depression care towards increased provision of psychological treatment and less drug treatment and sick-listing were in the desired direction according to Norwegian health care policy. However, the large and persistent differences in treatment rates between working-aged and older patients needs further investigation.publishedVersio
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Variation in general practitioners’ depression care following certification of sickness absence: a registry-based cohort study
'Oxford University Press (OUP)', 2020Co-Authors: Riiser Sharline, Haukenes Inger, Hetlevik Øystein, Smith-sivertsen Tone, Baste Valborg, Ruths SabineAbstract:Background Depression is more prevalent among women and people with low socio-economic status. Uncertainties exist about how general practitioner (GP) depression care varies with patients’ social position. Objective To investigate associations between patients’ gender and educational status combined and GP depression care following certification of sickness absence. Methods Nationwide registry-based cohort study, Norway, 2012–14. Reimbursement claims data from all consultations in general practice for depression were linked with information on socio-demographic data, social security benefits and depression medication. The study population comprised all individuals aged 25–66 years with taxable income, sick-listed with a new depression diagnosis in general practice in 2013 (n = 8857). We defined six intersectional groups by combining educational level and gender. The outcome was type of GP depression care during sick leave: follow-up consultation(s), Talking Therapy, medication and referral to secondary care. Associations between intersectional groups and outcome were estimated using generalized linear models. Results Among long-term absentees (17 days or more), highly educated women were less likely to receive medication compared to all other patient groups [relative risk (RR) ranging from 1.17 (95% confidence interval 1.03–1.33) to 1.49 (1.29–1.72)] and more likely to receive Talking Therapy than women with medium [RR = 0.90 (0.84–0.98)] or low [RR = 0.91 (0.85–0.98)] education. Conclusions Our findings suggest that GPs provide equitable depression care regarding consultations and referrals for all intersectional groups but differential drug treatment and Talking Therapy for highly educated women. GPs need to be aware of these variations to provide personalized care and to prevent reproducing inequity.publishedVersio
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Variation in general practitioners’ depression care following certification of sickness absence: a registry-based cohort study
2020Co-Authors: Riiser Sharline, Haukenes Inger, Hetlevik Øystein, Smith-sivertsen Tone, Baste Valborg, Ruths SabineAbstract:Background Depression is more prevalent among women and people with low socio-economic status. Uncertainties exist about how general practitioner (GP) depression care varies with patients’ social position. Objective To investigate associations between patients’ gender and educational status combined and GP depression care following certification of sickness absence. Methods Nationwide registry-based cohort study, Norway, 2012–14. Reimbursement claims data from all consultations in general practice for depression were linked with information on socio-demographic data, social security benefits and depression medication. The study population comprised all individuals aged 25–66 years with taxable income, sick-listed with a new depression diagnosis in general practice in 2013 (n = 8857). We defined six intersectional groups by combining educational level and gender. The outcome was type of GP depression care during sick leave: follow-up consultation(s), Talking Therapy, medication and referral to secondary care. Associations between intersectional groups and outcome were estimated using generalized linear models. Results Among long-term absentees (17 days or more), highly educated women were less likely to receive medication compared to all other patient groups [relative risk (RR) ranging from 1.17 (95% confidence interval 1.03–1.33) to 1.49 (1.29–1.72)] and more likely to receive Talking Therapy than women with medium [RR = 0.90 (0.84–0.98)] or low [RR = 0.91 (0.85–0.98)] education. Conclusions Our findings suggest that GPs provide equitable depression care regarding consultations and referrals for all intersectional groups but differential drug treatment and Talking Therapy for highly educated women. GPs need to be aware of these variations to provide personalized care and to prevent reproducing inequity
