Adherence to evidence-based guidelines for depression and anxiety disorders is associated with recording of the diagnosis

Objectives: To assess professionals' adherence to evidence-based guidelines and to investigate whether or not this is influenced by recording of the diagnosis and symptom severity. Method: Analysis of baseline cross-sectional data of a cohort study of 721 primary care patients with a confirmed diagnosis of a depressive or anxiety disorder. Information on the management of depressive and anxiety disorders was gathered from the electronic medical patient records. Guideline adherence was measured by an algorithm, based on performance indicators. Results: Forty-two percent of the patients with a depressive disorder was treated in accordance with the guideline, whereas 27% of the patients with an anxiety disorder received guideline-consistent care. The provision of care in line with current depression and anxiety guidelines vas around 50% for persons with both types of disorders. Documentation of an International Classification of Primary Care diagnosis of depression or anxiety disorder appeared to have a strong influence on guideline adherence. Symptom severity, however, did not influence guideline adherence. Conclusions: Adherence to depression and anxiety guidelines can be improved, even when the general practitioner makes the diagnosis and records it. Data on actual health care delivery and quality of care provide insight and may be useful in developing quality improvement activities. (C) 2009 Elsevier Inc. All rights reserved.