200210 A View of Older Patients' Explanatory Models of Depression: Through the Primary Care Providers' Lens

Wednesday, November 11, 2009: 8:45 AM

Marsha Nicole Wittink, MD MBE , Family Medicine and Community Health, University of Pennsylvania, Philadelphia, PA
THEORETICAL FRAMEWORK OF THE STUDY: Whether and how primary care providers consider older patients' perceptions of depression may have an impact on patients' acceptance of treatment.

STUDY OBJECTIVES: To examine primary care providers' beliefs about what drives older patients' acceptance or refusal of treatment.

RESEARCH AND ANALYTIC APPROACHES: Fifteen semi-structured interviews were conducted with primary care providers who were involved with intervention studies of depression management for older adults (PROSPECT and PRISM-E). We used the constant comparative method to identify themes related to patient acceptance of treatment.

MAJOR FINDINGS: Primary care providers felt that older patients often attribute depression to non-medical causes and discussed the need to “convince” older patients of the medical model for depression to enter them into standard treatments.

CONCLUSIONS: Since providers may believe that older patients hold explanatory models of depression not consistent with a biomedical model, some may try to convince their patients of a biomedical model in order to treat them, while others may avoid discussing depression with patients altogether. Whether or not physicians may make correct assumptions about older patients' attitudes towards depression, how physicians surmise patients' views of depression may influence whether and how depression is discussed in practice.

Learning Objectives:
to define and identify concerns primary care physicians discuss vis-a-vis treating depression in the elderly.

Keywords: Elderly, Depression

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a physician and researcher, the study described in this abstract was conducted by me as part of a career development grant (K23 from National Institute of Mental Health).
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.