Negotiating depression treatment with older adults: Primary care providers' perspectives

Abstract

Background. Primary care occupies a strategic position in the evaluation and treatment of depression in late life, yet many older patients do not initiate or adhere to treatments available in primary care.

Aim. To explore how primary care providers describe the process of discussing depression care with older adults.

Method. Semi-structured interviews conducted with 15 providers involved with intervention studies of depression management for older adults. We used the constant comparative method to identify themes related to negotiating the treatment of depression with older adults.

Results. Providers felt that older patients often attribute depression to non-medical causes. They talked about the challenges and described the need to ‘convince’ them of the medical model of depression.

Conclusion. How primary care physicians surmise patients' views of depression may influence the discussion of depression in practice. As medication is most often provided for depression treatment, some may feel compelled to convince their patients of biomedical explanations while others may avoid treating depression altogether.

Keywords:

• Depression treatment
• primary care
• providers

Acknowledgements

Dr. Marsha Wittink was supported by an NIMH Mentored Patient-Oriented Research Career Development Award (MH073658). Provider interviews were funded by the Advanced Center for Interventions and Services Research of the University of Pennsylvania.