biostudies-literatureUnknown11(3)Sandheimer C<h4>Objective</h4>To evaluate the implementation of a care manager organisation for common mental disorders and its association with antidepressant medication patterns on primary care centre (PCC) level, compared with PCCs without this organisation. Moreover, to determine whether a care manager organisation is associated with antidepressant medication patterns that is more in accordance with treatment guidelines.<h4>Design</h4>Register-based study on PCC level.<h4>Setting</h4>Primary care in Region Västra Götaland, Sweden.<h4>Participants</h4>All PCCs in the region. PCCs were analysed in three subgroups: PCCs with a care manager organisation during 2015 and 2016 (n=68), PCCs without the organisation (n=92) and PCCs that shifted to a care manager organisation during 2016 (n=42).<h4>Outcome measures</h4>Proportion of inadequate medication users, defined as number of patients <u>></u>18 years with a common mental disorder diagnosis receiving care at a PCC in the region during the study period and dispensed 1-179 defined daily doses (DDD) of antidepressants of total patients with at least 1 DDD. The outcome was analysed through generalised linear regression and a linear mixed-effects model.<h4>Results</h4>Overall, all PCCs had about 30%-34% of inadequate medication users. PCCs with a care manager organisation had significantly lower proportion of inadequate medication users in 2016 compared with PCCs without (-6.4%, p=0.02). These differences were explained by higher proportions in privately run PCCs. PCCs that shifted to a care manager organisation had a significant decrease in inadequate medication users over time (p=0.01).<h4>Conclusions</h4>Public PCCs had a more consistent antidepressant medication pattern compared with private PCCs that gained more by introducing a care manager organisation. It was possible to document a significant decrease in inadequate medication users, notwithstanding that PCCs in the region followed the guidelines to a comparatively high extent regardless of present care manager organisation.BMJ opene044959https://www.ebi.ac.uk/biostudies/studies/S-EPMC7938985biostudies-literatureImplementation of a care manager organisation and its association with antidepressant medication patterns: a register-based study of primary care centres in Sweden.PMC7938985Hedenrud TSandheimer CBjorkelund CHensing GMehlig KfalseImplementation of a care manager organisation and its association with antidepressant medication patterns: a register-based study of primary care centres in Sweden.<h4>Objective</h4>To evaluate the implementation of a care manager organisation for common mental disorders and its association with antidepressant medication patterns on primary care centre (PCC) level, compared with PCCs without this organisation. Moreover, to determine whether a care manager organisation is associated with antidepressant medication patterns that is more in accordance with treatment guidelines.<h4>Design</h4>Register-based study on PCC level.<h4>Setting</h4>Primary care in Region Västra Götaland, Sweden.<h4>Participants</h4>All PCCs in the region. PCCs were analysed in three subgroups: PCCs with a care manager organisation during 2015 and 2016 (n=68), PCCs without the organisation (n=92) and PCCs that shifted to a care manager organisation during 2016 (n=42).<h4>Outcome measures</h4>Proportion of inadequate medication users, defined as number of patients <u>></u>18 years with a common mental disorder diagnosis receiving care at a PCC in the region during the study period and dispensed 1-179 defined daily doses (DDD) of antidepressants of total patients with at least 1 DDD. The outcome was analysed through generalised linear regression and a linear mixed-effects model.<h4>Results</h4>Overall, all PCCs had about 30%-34% of inadequate medication users. PCCs with a care manager organisation had significantly lower proportion of inadequate medication users in 2016 compared with PCCs without (-6.4%, p=0.02). These differences were explained by higher proportions in privately run PCCs. PCCs that shifted to a care manager organisation had a significant decrease in inadequate medication users over time (p=0.01).<h4>Conclusions</h4>Public PCCs had a more consistent antidepressant medication pattern compared with private PCCs that gained more by introducing a care manager organisation. It was possible to document a significant decrease in inadequate medication users, notwithstanding that PCCs in the region followed the guidelines to a comparatively high extent regardless of present care manager organisation.2021-01-01T00:00:00Z2021 Mar2025-04-22T02:10:20.779Z2025-04-05T20:12:37.889ZS-EPMC79389853367437510.1136/bmjopen-2020-044959