Two-Year Effects of Quality Improvement Programs on Medication Management for Depression

Abstract
DEPRESSION is a major cause of disability worldwide1 and is common in primary care.2,3 Despite dissemination of practice guidelines for depression,4-6 significant underuse of evidence-based treatments for depression persists in primary care.7,8 Quality improvement (QI) efforts in primary care have been shown to increase rates of care and clinical outcomes for major depression for up to 8 months,9-12 but improvements in care were not sustained at longer-term follow-ups.13,14 We describe the impact of 2 QI interventions on the use of antidepressant medications and minor tranquilizers over 2 years.