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NICE's depression guidance doomed

Just 13 per cent of GPs are likely to follow National Institute for Clinical Excellence guidance on depression because patients often fail to take medication and attend follow-up appointments, Government- funded research suggests.

The researchers warned the very basis for depression guidelines in primary care was open to question. NICE published its draft guidelines on depression last month.

The study, which appeared on the Department of Health website earlier this month, evaluated a simple three-step depression guideline among 104 GPs.

Study lead Professor Chris Hawley, consultant psychiatrist at Queen Elizabeth II Hospital in Welwyn Garden City, Hertfordshire, said only 13 per cent of GPs strictly adhered to the guideline. The main reasons for not following it were failure of patients to turn up for appointments and not adhering to medication.

Professor Andre Tylee, professor of primary care mental health at King's College London and a member of the NICE depression guideline committee, said the guidelines in the study probably did not have much patient input.

Dr Helen Lester, senior

lecturer in primary care at the University of Birmingham and a GP in the city, said 13 per cent was a 'quite good' adherence rate considering the

complexities of mental health and the demands on general


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