The publication of numerous evidence-based guidelines for depression treatment has not been sufficient to improve daily practice; effective guideline implementation is therefore necessary. Efforts to implement depression treatment guidelines using educational approaches (including academic detailing) have yielded inconsistent and disappointing results. Effective implementation appears to require several elements: provider education; dedicated resources; structured care programs; and systematic follow-up of patients' treatment adherence and clinical outcomes. Key ingredients for improving depression treatment are similar to those for improving the care of most other chronic medical conditions.
Center for Health Studies, Group Health Cooperative, Seattle, Washington 98101, USA
Correspondence to Gregory E. Simon, MD MPH, Center for Health Studies, Group Health Cooperative, 1730 Minor Avenue no. 1600, Seattle, WA 98101, USA. Tel: +1 206 287 2979; fax: +1 206 287 2871; e-mail: firstname.lastname@example.org
Abbreviation QALY: quality-adjusted life years