medicina61巻11号

2024年10月発行

増大号特集 続・Quality Indicatorの実装とその改善—日々の診療に役立つ診療評価指標

各論　メンタルヘルス

うつ病の評価指標—プライマリ・ケアにおけるうつ病診療のQuality Indicator

著者： 坂田昌嗣¹

所属機関： ¹名古屋市立大学大学院医学研究科こころの発達医学寄附講座

ページ範囲：P.1928 - P.1931

文献概要

Point
◎うつ病診療のQIとして，スクリーニング，治療の選択，治療への反応などが挙げられるが，今後エビデンス蓄積が必要である．
◎国内のプライマリ・ケアにおけるうつ病診療のQIは確立していないが，精神科医療における処方率改善の試み「EGUIDE」が参考となる．
◎うつ病診療の多くの指標はまだその適切性を満たすとはいえず，検証が必要といえる．

参考文献

1）Nishi D, et al：Prevalence of mental disorders and mental health service use in Japan. Psychiatry Clin Neurosci 73：458-465, 2019 PMID 31141260

2）Donabedian A：Evaluating the quality of medical care. Milbank Mem Fund Q 44：Suppl 166-206, 1996 PMID 5338568

3）Petrosyan Y, et al：Quality indicators for care of depression in primary care settings；A systematic review. Syst Rev 6：s13643-017-0530-7, 2017 PMID 28673356

4）Hashimoto N, et al：Characteristics of discharge prescriptions for patients with schizophrenia or major depressive disorder；Real-world evidence from the Effectiveness of Guidelines for Dissemination and Education（EGUIDE）psychiatric treatment project. Asian J Psychiatr 63：102744, 2021 PMID 34325252

5）Yamada H, et al：A dissemination and education programme to improve the clinical behaviours of psychiatrists in accordance with treatment guidelines for schizophrenia and major depressive disorders；The Effectiveness of Guidelines for Dissemination and Education in Psychiatric Treatment（EGUIDE）project. BJPsych Open 8：e83, 2022 PMID 35446248

6）Qaseem A, et al；Clinical Guidelines Committee of the American College of Physicians：Quality indicators for major depressive disorder in adults； A review of performance measures by the American College of Physicians. Ann Intern Med 177：507-513, 2024 PMID 38437692

7）Qaseem A, et al；Clinical Guidelines Committee of the American College of Physicians：Nonpharmacologic and pharmacologic treatments of adults in the acute phase of Major Depressive Disorder；A living clinical guideline from the American College of Physicians. Ann Intern Med 176：239-252, 2023 PMID 36689752

8）Petrosyan Y, et al：Quality indicators for care of depression in primary care settings；A systematic review. Syst Rev 6：126, 2017 PMID 28673356