TY - JOUR KW - Adult KW - Aged KW - Attitude of Health Personnel KW - Case Management KW - Case managers KW - Chronic Disease KW - Cooperative Behavior KW - Depression/therapy KW - Depressive Disorder/therapy KW - Female KW - General Practitioners KW - Humans KW - Male KW - Middle Aged KW - Patient Care Team KW - Primary Health Care KW - Professional Role KW - Psychotherapy KW - Qualitative Research KW - Quality of Health Care KW - Sweden KW - primary care KW - collaborative care KW - coordinated care KW - Family Medicine KW - Nursing Interventions KW - patient care continuity KW - Psychiatry AU - S. A. W. Hammarberg AU - D. Hange AU - M. Andre AU - C. Udo AU - I. Svenningsson AU - C. Bjorkelund AU - E. L. Petersson AU - J. Westman A1 - AB - Objective: Explore general practitioners' (GPs') views on and experiences of working with care managers for patients treated for depression in primary care settings. Care managers are specially trained health care professionals, often specialist nurses, who coordinate care for patients with chronic diseases. Design: Qualitative content analysis of five focus-group discussions. Setting: Primary health care centers in the Region of Vastra Gotaland and Dalarna County, Sweden. Subjects: 29 GPs. Main outcome measures: GPs' views and experiences of care managers for patients with depression. Results: GPs expressed a broad variety of views and experiences. Care managers could ensure care quality while freeing GPs from case management by providing support for patients and security and relief for GPs and by coordinating patient care. GPs could also express concern about role overlap; specifically, that GPs are already care managers, that too many caregivers disrupt patient contact, and that the roles of care managers and psychotherapists seem to compete. GPs thought care managers should be assigned to patients who need them the most (e.g. patients with life difficulties or severe mental health problems). They also found that transition to a chronic care model required change, including alterations in the way GPs worked and changes that made depression treatment more like treatment for other chronic diseases. Conclusion: GPs have varied experiences of care managers. As a complementary part of the primary health care team, care managers can be useful for patients with depression, but team members' roles must be clear. KEY POINTS A growing number of primary health care centers are introducing care managers for patients with depression, but knowledge about GPs' experiences of this kind of collaborative care is limited. GPs find that care managers provide support for patients and security and relief for GPs. GPs are concerned about potential role overlap and desire greater latitude in deciding which patients can be assigned a care manager. GPs think depression can be treated using a chronic care model that includes care managers but that adjusting to the new way of working will take time. AD - Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet , Stockholm , Sweden.; Academic Primary Health Care Centre, Stockholm County Council , Stockholm , Sweden.; Department of Public Health and Community Medicine, Primary Health Care, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg , Gothenburg , Sweden.; Department of Public Health and Caring Sciences - Family Medicine and Preventive Medicine, Uppsala University , Uppsala , Sweden.; School of Education, Health and Social Studies, Dalarna University , Falun , Sweden.; CKF, Center for Clinical Research Dalarna , Falun , Sweden.; Department of Public Health and Community Medicine, Primary Health Care, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg , Gothenburg , Sweden.; Narhalsan Research and Development Primary Health Care, Region Vastra Gotaland , Gothenburg , Sweden.; Department of Public Health and Community Medicine, Primary Health Care, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg , Gothenburg , Sweden.; Department of Public Health and Community Medicine, Primary Health Care, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg , Gothenburg , Sweden.; Narhalsan Research and Development Primary Health Care, Region Vastra Gotaland , Gothenburg , Sweden.; Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet , Stockholm , Sweden.; Academic Primary Health Care Centre, Stockholm County Council , Stockholm , Sweden.; Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet , Stockholm , Sweden. BT - Scandinavian journal of primary health care C5 - Education & Workforce CP - 3 CY - United States DO - 10.1080/02813432.2019.1639897 IS - 3 JF - Scandinavian journal of primary health care LA - eng M1 - Journal Article N2 - Objective: Explore general practitioners' (GPs') views on and experiences of working with care managers for patients treated for depression in primary care settings. Care managers are specially trained health care professionals, often specialist nurses, who coordinate care for patients with chronic diseases. Design: Qualitative content analysis of five focus-group discussions. Setting: Primary health care centers in the Region of Vastra Gotaland and Dalarna County, Sweden. Subjects: 29 GPs. Main outcome measures: GPs' views and experiences of care managers for patients with depression. Results: GPs expressed a broad variety of views and experiences. Care managers could ensure care quality while freeing GPs from case management by providing support for patients and security and relief for GPs and by coordinating patient care. GPs could also express concern about role overlap; specifically, that GPs are already care managers, that too many caregivers disrupt patient contact, and that the roles of care managers and psychotherapists seem to compete. GPs thought care managers should be assigned to patients who need them the most (e.g. patients with life difficulties or severe mental health problems). They also found that transition to a chronic care model required change, including alterations in the way GPs worked and changes that made depression treatment more like treatment for other chronic diseases. Conclusion: GPs have varied experiences of care managers. As a complementary part of the primary health care team, care managers can be useful for patients with depression, but team members' roles must be clear. KEY POINTS A growing number of primary health care centers are introducing care managers for patients with depression, but knowledge about GPs' experiences of this kind of collaborative care is limited. GPs find that care managers provide support for patients and security and relief for GPs. GPs are concerned about potential role overlap and desire greater latitude in deciding which patients can be assigned a care manager. GPs think depression can be treated using a chronic care model that includes care managers but that adjusting to the new way of working will take time. PP - United States PY - 2019 SN - 1502-7724; 0281-3432 SP - 273 EP - 282 EP - T1 - Care managers can be useful for patients with depression but their role must be clear: a qualitative study of GPs' experiences T2 - Scandinavian journal of primary health care TI - Care managers can be useful for patients with depression but their role must be clear: a qualitative study of GPs' experiences U1 - Education & Workforce U2 - 31286807 U3 - 10.1080/02813432.2019.1639897 VL - 37 VO - 1502-7724; 0281-3432 Y1 - 2019 Y2 - Sep ER -