Obstacles facing primary health care physicians in diagnosing and managing depressed patients in the Tabuk area of Saudi Arabia

Obstacles facing primary health care physicians in diagnosing and managing depressed patients in the Tabuk area of Saudi Arabia

MIDDLE EAST JOURNAL OF FAMILY MEDICINE VOLUME 11 ISSUE 2

Hashim Hassan Ahmad Department of Family Medicine, North West Armed Forces Hospital (NWAFH), Tabuk City, Saudi Arabia.

Present address: Faculty of Medicine, King Saud Bin Abdul Aziz University for Health Sciences, King Fahad Medical City, PO Box 59046, 11525 Riyadh, Kingdom of Saudi Arabia.

Correspondence: Hashim Hassan Ahmad, Faculty of Medicine, King Saud Bin Abdul Aziz University for Health Sciences, King Fahad Medical City, PO Box 59046, 11525 Riyadh, Kingdom of Saudi Arabia Email: hhahmed53@hotmail.com

Abstract

Background: Depression is one of the most common morbidities worldwide, including in Saudi Arabia. It is vital to diagnose and manage the disease at the primary health care level. All barriers interfering with this task should be identified and corrective measures implemented.

Objective: To assess the barriers facing primary health care physicians in diagnosing and managing depressed patients in primary health care centers

Design: Cross sectional study. Setting: All primary health care centers which serve Military personnel and their dependents at the North West Armed Forces Hospital, Tabuk City, Saudi Arabia.

Subjects: All primary health care physicians ( n=75) working at the time of the study in primary health care centers that belong to North West Armed Forces Hospital.

Methods: Subjects completed a self-administered questionnaire consisting of personal and sociodemographic data, organizational and patient’s barriers to diagnose and treat depression in primary care settings.

Results: All 75 physicians responded and returned the questionnaires. About 78% agreed that the diagnosis of depression is their responsibility and only 4% disagreed. More than two-thirds (69.3%) agreed and 9.3% disagreed that treatment of depression is their responsibility. More than half (57.3%) agreed that lack of knowledge of diagnostic criteria of depression was a limiting factor while 73.3% agreed that lack of knowledge of treatment of depression was another limiting factor. About 90% or more physicians agreed that the appointment time was too short for taking adequate history, to provide counselling/education; that mental health professionals were not available within the PHC setting; that patients or their families were reluctant to accept the diagnosis of depression and that patients were reluctant to take antidepressants.

Conclusion: Continuous medical education is required for the health care providers on depression and needs to be instituted and adequate resources for counseling services and antidepressant medications at primary care level need be made available. There is also a need to improve the quality and to integrate services with the mental health referral services. Efforts to destigmatize depression may result in increased rate of diagnosis and treatment of depression in the primary care setting, improving outcomes in the study population.