Volume 190 - Issue 5
Impact of an educational intervention on general practitioners’ skills in cognitive behavioural strategies
Authors: Grant A Blashki, Leon Piterman, Graham N Meadows, David M Clarke, Vasuki Prabaharan, Jane M Gunn and Fiona K Judd
Med J Aust 2009; 190 (5): 287-288. || doi: 10.5694/j.1326-5377.2009.tb02409.x
Published online: 2 March 2009
Published online: 2 March 2009
In reply: Our words in conclusion to our article were carefully chosen as: “Competency in CBS [cognitive behavioural strategies] in highly motivated GPs [general practitioners] can be improved by a brief training intervention”1 (italics added) — not that all such interventions will lead to improvements for all GPs, but that well designed and conducted training for selected GPs can do so. Research so far leaves open the possibility of large enough effect sizes for GP mental health training to be relevant to policy.2 The review cited by Kljakovic was limited in scope and noted the poor quality of studies included.3
A drop-out bias in our study, as proposed, seems most unlikely to us. Rather than being imposed, this training model was developed with GPs, by GPs and for GPs, and so might achieve better results than previous interventions studied. Funding for GP participation such as that more commonly available in drug studies might have increased participation. It is true that a great deal of training has been offered to GPs, and we hold that our study shows that such training can lead to GPs significantly improving their skills in this area. GP training should be considered within multifaceted interventions to improve primary mental health care.4
References
- Blashki GA, Piterman L, Meadows GN, et al. Impact of an educational intervention on general practitioners’ skills in cognitive behavioural strategies: a randomised controlled trial. Med J Aust 2008; 188 (12 Suppl): S129-S132. <eMJA full text>
- Mihalopoulos C, Kiropoulos L, Shih ST, et al. Exploratory economic analyses of two primary care mental health projects: implications for sustainability. Med J Aust 2005; 183 (10 Suppl): S73-S76. <eMJA full text>
- Christensen H, Griffiths KM, Gulliver A, et al. Models in the delivery of depression care: a systematic review of randomised and controlled intervention trials. BMC Fam Pract 2008; 9: 25. 0_i1091840
- Gunn J, Diggens J, Hegarty K, Blashki G. A systematic review of complex system interventions designed to increase recovery from depression in primary care. BMC Health Serv Res 2006; 6: 88. 0_i1091844