Long-term effectiveness of disseminating quality improvement for depression in primary care.

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Abstract
DEPRESSIVE disorders and symptoms are prevalent among primary care patients, can persist for years, and are associated with decrements in functioning and wellbeing.1-5 Depression is expected to become the second leading cause of disability worldwide over the next decade.6,7 Most persons with depression receive their care in primary health care settings,8 yet only 50% are recognized as depressed.9,10 Because rates of appropriate treatments for depression are moderate to low in such settings,11-13 improving quality of care is essential for limiting the dysfunction associated with depression. This article addresses whether dissemination of short-term, guideline-based quality improvement (QI) interventions for depression to primary care practices improves patients' clinical outcomes and quality of life over 2 years, relative to usual care (UC).