Framing the process in the implementation of care for people with generalized anxiety disorder in primary care: a qualit
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(2020) 21:237
RESEARCH ARTICLE
Open Access
Framing the process in the implementation of care for people with generalized anxiety disorder in primary care: a qualitative evidence synthesis Ana Toledo-Chávarri1,2,3,4, Vanesa Ramos-García1,4* , Alezandra Torres-Castaño1,4, María M Trujillo-Martín1,2,3,4, Wenceslao Peñate Castro5, Isabel Del Cura-Castro2,6,7, Pedro Serrano-Aguilar2,3,4,8 and Lilisbeth Perestelo-Pérez2,3,4,8
Abstract Background: Generalized anxiety disorder (GAD) is one of the most common mental disorders in primary care (PC). GAD has low remission and high relapse rates over long follow-up periods. Qualitative evidence was synthesized to understand the implementation of care and treatment options for people with GAD in PC. Methods: Research published from 2008 to September 2020 was searched in five databases (MEDLINE, EMBASE, CINAHL, WOS and PsycArticles). Studies that used qualitative methods for data collection and analysis to investigate the implementation of care and treatment options for people with GAD in PC and outpatient settings were included. Non-qualitative studies, mixed methods studies that did not separately report qualitative findings and studies in languages other than English or Spanish were excluded. We used the Confidence in the Evidence from Reviews of Qualitative Research (CERQual) framework to assess the overall confidence in the findings. Results: The results with a moderate level of confidence showed that the trajectory of care for people with GAD in PC and outpatient settings is long and fluctuates over time, involving multiple difficulties in accessing and maintaining initial treatment or successive treatment options. In addition, there are wide variations in the preferences for and acceptability of different treatment options. The results with a high level of confidence indicated that more information on GAD and its treatment options is needed for PC practitioners, GAD patients and their carers. The results with a low level of confidence suggested that patients use antidepressants for longer than recommended and that the interruption of treatment is not usually planned. (Continued on next page)
* Correspondence: [email protected] 1 Canary Islands Health Research Institute Foundation, Tenerife, Spain 4 The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), Tenerife, Spain Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is
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