Effects of mental health training and clinical audit on general practitioners' management of common XXXX .

@entity1 @entity308 @entity148 @entity146
OBJECTIVE: To evaluate the effects of a seminar-based training program and clinical practice audit on general practitioners' (GPs') knowledge and management of common @entity146 . DESIGN: Survey of GPs' knowledge before and after training, and clinical practice audit and re-audit after feedback. @entity1 AND SETTING: GP volunteers from around Australia in 1998-1999: 1008 completed the pre-training test, 190 the post-training test, 386 the first audit (33235 @entity1 ), and 157 of these the re-audit (13280 @entity1 ), with 57 undertaking both audit and training. INTERVENTIONS: Four-seminar, 12-hour training program focused on improving GPs' capacity to identify and manage @entity1 with @entity308 and @entity148 ; practice audit with @entity1 - and practice-based feedback on diagnosis and treatment of common @entity146 . MAIN OUTCOME MEASURES: Scores on pre- and post-training knowledge tests; self-rated improvements in confidence in managing @entity1 with @entity146 after training; rates of psychological diagnoses and treatment by GPs on first audit and re-audit. RESULTS: GPs' knowledge of pharmacological treatments and clinical management improved after the training program (P<0.001), and 97% of GPs reported increased confidence in their management skills. GPs who undertook training had higher diagnosis rates for common @entity146 in the first audit than those who did not undertake training (36% versus 29%; P<0.001), and their diagnosis rates increased over time (36% to 39%; P<0.01), while those of GPs who did not undertake training were unchanged. Similarly, GPs who undertook training provided more mental health treatments than those who did not (30% versus 27% in the first audit [P<0.001], and 31% versus 24% at reaudit [P<0.001]). They also place greater emphasis on use of nonpharmacological treatments (24% versus 21% at first audit [P<0.001], and 25% versus 19% at re-audit [P<0.001]). CONCLUSION: Clinical audits may heighten @entity146 , but, on their own, they do not improve mental health practice. A relatively brief but skills-based training program may contribute to better management of @entity1 with common @entity146 by increasing GPs' confidence and competence.
