Diverse voices, simple desires: a conceptual design for primary care to respond to depression and related disorders.

BACKGROUND: The World Health Organization and the World Organization of Family Doctors have called for 'doable' and 'limited' tasks to integrate mental health into primary care. Little information is provided about tasks GPs can undertake outside of guidelines that suggest to prescribe medication and refer to specialists. OBJECTIVES: The reorder study aimed to gather diverse patient and community perspectives to inform the development of an effective system of depression care. METHOD: Five hundred and seventy-six patients completed computer-assisted telephone interviews. Two hundred and seventy-six community stakeholders completed a modified two round Delphi. Responses were analysed to identify tasks and these were synthesised into a conceptual design. RESULTS: Fifteen core tasks were identified, 5 were agreed upon and a further 10 identified by each group but not agreed upon. Listen, understand and empathize, provide thorough and competent diagnosis and management, follow-up and monitor patients, be accessible and do not rush appointments and provide holistic approach and tailor care to individual needs were agreed on. Other tasks included: develop plans with patients, assess for severity and suicide risk, account for social factors, be well trained in depression care and offer a range of treatment options, appropriate and timely referral, support and reassurance, educate patients about depression, prescribe appropriately and manage medication and be positive and encouraging. CONCLUSIONS: The tasks form the basis of a conceptual design for developing a primary care response to depression. They fit within three domains of care: the relational, competency and systems domains. This illustrates tasks for GPs beyond prescription and referral.

Establishing the Victorian Primary Care Practice Based Research Network.

BACKGROUND: Practice based research networks comprise research academics and primary care practitioners who have the mutual goal of supporting the development and implementation of research that is necessary to build the evidence base that informs both primary healthcare practitioners and policy makers. This article describes the establishment of the Victorian Primary Care Practice Based Research Network (VicReN), which was established in 2007 and has grown to over 100 members. METHOD: The aim of this article is to discuss the key factors in the development of the organisational structure of VicReN, and to describe the outcome measures used to evaluate the network. RESULTS: VicReN has a diverse primary care membership. Members' different research needs have been addressed through numerous capacity building activities. The absence of core funding beyond the development phase has led to an innovative funding model. DISCUSSION: This article outlines a viable and sustainable background practice based research network model in the Australian environment that may assist other academic departments of general practice and rural health interested in establishing a practice based research network.