Utilization of clinical practice guidelines and interprofessional collaboration in depression management in Swiss primary care: a cross-sectional survey study among primary care physicians.

Objectives: To (i) investigate the current state of depression management in Swiss primary care post-COVID-19, focusing on the utilization of guidelines or associated tools, (ii) explore potential associations with depression management, and (iii) evaluate availability of and communication with psychiatrists and psychotherapists.

Methods: A previously developed self-report questionnaire, covering screening, diagnosis, management, and interprofessional collaboration, was distributed online, with a supplementary paper version, to 168 Swiss primary care physicians (PCPs) participating in the Swiss Sentinel Surveillance System. Multivariable logistic regressions explored associations.

Results: Of the 168 primary care physicians invited to participate, 116 completed the survey (response rate: 69%). Among these, 61% utilized guidelines for depression management, with statistically significant associations towards increased guideline utilization for PCPs with some psychiatric training as residents (odds ratio [OR] 4.13; 95% confidence interval (95% CI) 1.27, 16.02) and decreased utilization for the age group 60-81 (OR 0.29; 95% CI 0.09, 0.93). Guideline utilization was associated with perceived competency in prescribing antidepressants (OR 3.51; 95% CI 1.21, 11.08). The majority reported difficulties in organizing therapy with mental health specialists and rarely received feedback after patient referrals.

Conclusion: While the utilization of guidelines among participants was inconsistent, over 60% indicated using either guidelines, tools, or both. The study highlights systemic issues in interprofessional collaboration between PCPs and mental health specialists that require attention.