With an ageing society and the increasing prevalence of multimorbidity, the prevalence and complexity of mental illness are increasing. Depression is the most common diagnosis. General practitioners (GPs) play an important role in the care of patients with depression, as they make the initial diagnosis and are responsible for treatment. The detection and treatment of depression presents GPs with special challenges. Somatic comorbidities can mask a depression and make it difficult to select a suitable therapy and implementation, endangering both the success of the therapy and the safety of the depression treatment. The implementation of guideline recommendations might be limited.
Our goal is to support GPs in coping with these challenges and to improve the care of patients with depression. In three research projects each on diagnosis, treatment and implementation, new instruments adapted to the Primary Care context are systematically developed along the Chronic Care Model (CCM). A new algorithm will be developed to support diagnostics; in its generation process, physiological and GP-related factors will be considered in addition to established parameters. A new approach for the detection of suicidal behaviour will be piloted and optimized. Instruments of psychoeducation, monitoring/case management and medication control will be developed and evaluated. Barriers and potentials for the implementation of innovations in health care are systematically identified and tailoured solutions are developed, optimised and evaluated.
Promising scientists will be trained who will further develop clinical research in the field of general practice and will support both service providers and health care payers in improving care structures, processes and results. For this purpose, a comprehensive qualification concept has been developed, which enables graduates of relevant subjects with initial work experience, as well as prospective GPs to receive a structured scientific education parallel to their clinical training.
The cooperation of two institutes for general medicine with institutes for clinical psychology, psychiatry and psychosomatics at one location, the international award and experience of the PIs and international cooperation partners in research and education distinguish POKAL as a unique project, which can improve the care of patients with depression in Primary Care.