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Depression in adults: recognition and management [CG90]

Measuring the use of this guidance

Recommendation: 1.1.3.1

When families or carers are involved in supporting a person with severe or chronic depression, consider: providing written and verbal information on depression and its management, including how families or carers can support the person offering a carer's assessment of their caring, physical and mental health needs if necessary providing information about local family or carer support groups and voluntary organisations, and helping families or carers to access these negotiating between the person and their family or carer about confidentiality and the sharing of information.

What was measured: The proportion of adult hospital inpatients with a primary diagnosis of anxiety or depression where a family member, friend, or carer was identified as the main source of support to the service user were provided information about support services and/or support plan.
Data collection end: September 2017
62%
Area covered: England
Source: National Clinical Audit of Anxiety and Depression

What was measured: The proportion of adult hospital inpatients with a primary diagnosis of anxiety or depression where a family member, friend, or carer was identified as the main source of support to the service user were offered a carer’s assessment.
Data collection end: September 2017
25%
Area covered: England
Source: National Clinical Audit of Anxiety and Depression


Recommendation: 1.1.4.2

"In addition to assessing symptoms and associated functional impairment, consider how the following factors may have affected the development, course and severity of a person's depression: any history of depression and comorbid mental health or physical disorders any past history of mood elevation (to determine if the depression may be part of bipolar disorder[6]) any past experience of, and response to, treatments the quality of interpersonal relationships living conditions and social isolation."

What was measured: Proportion of patients aged 18 or over with a new diagnosis of depression in the preceding 1 April to 31 March, who have had a bio-psychosocial assessment by the point of diagnosis. The completion of the assessment is to be recorded on the same day as the diagnosis is recorded.
Data collection end: March 2018
6.3%
Number that met the criteria: 35110 / 560007
Area covered: England
Source: Indicators no longer in QOF (INLIQ)


Recommendation: 1.5.25

When prescribing antidepressants, explore any concerns the person with depression has about taking medication, explain fully the reasons for prescribing, and provide information about taking antidepressants, including: the gradual development of the full antidepressant effect the importance of taking medication as prescribed and the need to continue treatment after remission potential side effects the potential for interactions with other medications the risk and nature of discontinuation symptoms with all antidepressants, particularly with drugs with a shorter half-life (such as paroxetine and venlafaxine), and how these symptoms can be minimised the fact that addiction does not occur with antidepressants. Offer written information appropriate to the person's needs.

What was measured: The proportion of adult hospital inpatients with a primary diagnosis of anxiety or depression who were given verbal and/or written information about their medication prior to discharge.
Data collection end: September 2017
73%
Area covered: England
Source: National Clinical Audit of Anxiety and Depression


Recommendation: 1.10.1.1

The assessment of a person with depression referred to specialist mental health services should include: their symptom profile, suicide risk and, where appropriate, previous treatment history associated psychosocial stressors, personality factors and significant relationship difficulties, particularly where the depression is chronic or recurrent associated comorbidities including alcohol and substance misuse, and personality disorders.

What was measured: The proportion of adult hospital inpatients with a primary diagnosis of anxiety or depression who had an assessment which considered whether the person had a history of trauma.
Data collection end: September 2017
79%
Area covered: England
Source: National Clinical Audit of Anxiety and Depression

What was measured: The proportion of adult hospital inpatients with a primary diagnosis of anxiety or depression who had an assessment which included details about the person’s past response to treatment.
Data collection end: September 2017
81%
Area covered: England
Source: National Clinical Audit of Anxiety and Depression

What was measured: The proportion of adult hospital inpatients with a primary diagnosis of anxiety or depression who had an assessment which included difficulties relating to social situation.
Data collection end: September 2017
97%
Area covered: England
Source: National Clinical Audit of Anxiety and Depression

What was measured: The proportion of adult hospital inpatients with a primary diagnosis of anxiety or depression who had an assessment where alcohol intake was documented.
Data collection end: September 2017
70%
Number that met the criteria: / 83
Area covered: England
Source: National Clinical Audit of Anxiety and Depression

What was measured: The proportion of adult hospital inpatients with a primary diagnosis of anxiety or depression who had an assessment where substance misuse was documented.
Data collection end: September 2017
91%
Area covered: England
Source: National Clinical Audit of Anxiety and Depression


Recommendation: 1.10.1.5

Teams working with people with complex and severe depression should develop comprehensive multidisciplinary care plans in collaboration with the person with depression (and their family or carer, if agreed with the person). The care plan should: identify clearly the roles and responsibilities of all health and social care professionals involved develop a crisis plan that identifies potential triggers that could lead to a crisis and strategies to manage such triggers be shared with the GP and the person with depression and other relevant people involved in the person's care.

What was measured: The proportion of adult hospital inpatients with a primary diagnosis of anxiety or depression who had a care plan.
Data collection end: September 2017
91%
Area covered: England
Source: National Clinical Audit of Anxiety and Depression

What was measured: The proportion of adult hospital inpatients with a primary diagnosis of anxiety or depression who had a care plan was jointly developed between the service user and clinician.
Data collection end: September 2017
82%
Area covered: England
Source: National Clinical Audit of Anxiety and Depression



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