Download Treatment of Anxiety

Treatment of Anxiety
(Indicator Set: Primary Health Care Providers)
Descriptive
Definition
Percentage of patient population, age 18 and older, with a diagnosis of
panic disorder or generalized anxiety disorder who were offered
treatment or referral to a mental health provider.
Method of
Calculation
Numerator
Number of individuals in the denominator who were
offered treatment or referral to a mental health
provider within the past 12 months.
Inclusions
• Individual is in the denominator
• Individual received at least one of the following
from their primary health care (PHC) provider
within the past 12 months:
− A prescription for anti-anxiety medication
− A referral to a mental health provider
− An offer for non-pharmacological treatment
(psychological interventions: individual
non-facilitated self-help, individual guided
self-help and psychoeducational groups)
Exclusions
None
Denominator
Number of PHC clients/patients, age 18 and older,
with a diagnosis of panic disorder or generalized
anxiety disorder.
Inclusions
• PHC client/patient
• Age of individual is at least 18 years
• Individual has a diagnosis of at least one of the
following conditions:
− Panic disorder
− Generalized anxiety disorder
Exclusions
None
Data Source
Electronic medical record
Notes
• A PHC client/patient is an individual who has had contact with the
provider at least once in the past year and has a record with the
provider dating back at least two years.
• Mental health provider: A caregiver with mental health expertise
(for example, psychologist, psychiatrist, occupational therapist,
psychiatric registered nurse or social worker).
Treatment of Anxiety
(Indicator Set: Primary Health Care Providers) (cont’d)
Interpretation
• A high rate for this indicator can be interpreted as a positive result.
Indicator Rationale Anxiety disorders are among the most common mental health disorders,
but because of their chronic and disabling nature their prevalence is
often underestimated.1–4 Evidence suggests that between 10% and 29%
of Canadians will experience an anxiety disorder during their lifetime.5
Anxiety disorders cause significant distress for patients and their families
and considerable economic costs to society, resulting in overuse of
psychiatric and non-psychiatric medical services, reduced productivity,
and increased risk of suicide compared with the general population.4, 5
Panic disorder is a chronic condition characterized by recurrent,
unexpected panic attacks followed by excessive worry of another attack,
the consequences of attacks and behavioural changes associated
with attacks. Generalized anxiety disorder is a chronic anxiety disorder
characterized by persistent, excessive and difficult-to-control worry. Both
panic disorder and generalized anxiety disorder can be treated with
psychological and pharmacologic interventions, alone or in combination.
Most Canadians access the health care system through their PHC
provider, and research suggests that between 1 in 5 and 1 in 12 patients
visiting their PHC provider present with symptoms consistent with an
anxiety disorder.5 The role of PHC providers is critical in identifying
symptoms of anxiety in their patients, diagnosing an anxiety disorder
and, in many cases, treating them for the condition.
References
1.
American Psychiatric Association. Diagnostic and Statistical Manual
of Mental Disorders, Fourth Edition, Text Revision . Arlington,
Virginia: American Psychiatric Association; 2000
2.
Antony M. and Swinson R. Anxiety Disorders and Their Treatment:
A Critical Review of the Evidence-Based Literature. Ottawa, Ontario:
Health Canada; 1996. www.phac-aspc.gc.ca/mh-sm/pdf/
anxiety_review.pdf.
3.
Kessler RCP, Berglund PM, Demler OM, Jin RM, Walters EEM.
Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV
Disorders in the National Comorbidity Survey Replication. [Article].
Archives of General Psychiatry. June, 2005;62(6):593-602.
4.
Stein MBM, Sherbourne CDP, Craske MGP, et al. Quality of Care for
Primary Care Patients With Anxiety Disorders. [Article]. American
Journal of Psychiatry. December, 2004;161(12):2230-2237.
5.
Clinical practice guidelines. Management of anxiety disorders.
Can J Psychiatry. July, 2006;51(8 Suppl 2):9S-91S. PM:16933543.
For more information on the PHC indicators, data sources and reporting initiatives, visit CIHI’s
website at www.cihi.ca/phc or send us an email at [email protected].
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