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Major Depressive Disorder in Primary Care: Implementing Evidence-Based Care Pathways

Major Depressive Disorder in Primary Care: Implementing Evidence-Based Care Pathways



Time to Complete

45 minutes


August 7, 2012


August 7, 2013

Maximum Credits

0.75 / AMA PRA Category 1 Credit(s)TM

Accredited Provider

Accredited by Primary Care Network

If you have any questions relating to the accreditation or other issues with this activity, please contact Primary Care Network
Phone: 417-841-3658
Phone: 800-769-7565

Commercial Supporter

This activity is supported through an educational grant from Lilly USA, LLC.

Program Description

Major depressive disorder (MDD) is a leading cause of disability and premature mortality, but it remains underdiagnosed and undertreated. Effective screening, early diagnosis, and appropriate treatment can greatly mitigate the harmful and debilitating effects of this chronic psychiatric disorder. However, evidence suggests that management of depression is challenging for primary care providers (PCPs). First, PCPs must recognize and treat a wide range of manifestations in diverse populations. Second, it may be difficult to communicate the diagnosis of MDD to patients in a manner that promotes acceptance. Finally, selecting appropriate treatment from various psychosocial and pharmacologic options can be a formidable task. To ensure that an individualized patient-centered treatment plan is formulated, PCPs should remain knowledgeable about the clinical profiles of available agents. Importantly, they must implement treatment and monitoring strategies to achieve remission and full functional recovery in patients. This activity presents a comprehensive overview of best practices in screening, diagnosis, and treatment of MDD.

Intended Audience

This activity is targeted to any primary care provider who treats patients with major depressive disorder.

Educational Objectives

After participating in this educational activity, participants should be better able to:
  • Conduct a comprehensive assessment and differential diagnosis of patients presenting with depressive symptomatology
  • Select and initiate antidepressants, psychotherapies, and/or behavioral interventions across heterogeneous patient populations with major depressive disorder
  • Monitor and adjust treatments for major depressive disorder over time to improve patient adherence and achieve and maintain remission

Accreditor Disclosure Of Conflicts Of Interest Policy

It is the policy of PCN to ensure all its sponsored educational activities are planned, developed, and conducted in accordance with the ACCME’s Essential Areas and Policies. In accordance with ACCME requirements, PCN has Conflict of Interest and Disclosure Policies that are designed to ensure that PCN-sponsored educational activities are fair balanced, independent, evidence-based and based on scientific rigor.

Primary Care Network’s Resolution of Personal Conflicts of Interest (COI) Policy aims to ensure that all conflicts are resolved prior to the activity, content is developed and presented free of commercial bias, and is in the interest of promoting improvements or quality in healthcare. All individuals who are in a position to influence and/or control content of a PCN-sponsored activity are required to disclose to the participants any real or apparent conflict of interest related to the activity. The educational content is also reviewed for independence and content validation by an independent external reviewer and internal clinical reviewer. Independence is also monitored through the activity and overall program evaluation process.


Larry Culpepper, MD, MPH

Professor of Family Medicine
Boston University School of Medicine
Boston, Massachusetts

Dr. Larry Culpepper
Advisory board: AstraZeneca, Forest Laboratories, LaboPharm USA, Lilly USA, Merck, Pfizer, Takeda, and Travis
Speaker's bureau: Merck

Philip R. Muskin, MD

Professor of Clinical Psychiatry
Columbia University
Chief of Service: Consultation-Liaison Psychiatry
New York-Presbyterian Hospital/Columbia University Medical Center
New York, New York

Dr. Philip Muskin
Speaker's bureau: Bristol-Myers Squibb

Review Committee Disclosure

In accordance with Primary Care Network (PCN) policy, all content is reviewed by external independent peer reviewers for balance, objectivity, and commercial bias. The peer reviewers, staff, and other individuals who control content have no relevant financial relationships to disclose.


Online publication




AMA PRA Category 1 Credit(s)TM

Accreditation Statement

Primary Care Network is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Designation Statement

Physicians: Primary Care Network designates this enduring material for a maximum of 0.75 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Nonphysicians: All other healthcare professionals will be issued a certificate of participation.

Unlabeled Use Declaration

During this activity, author(s) may discuss an unlabeled use or an investigational use not approved for a commercial product. Each author is required to disclose this information to the participants when referring to an unlabeled or investigational use.


It is hoped that information in this activity will be useful in the management of your patients. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patients' conditions, review of any applicable manufacturers' product information, and comparison with recommendations of recognized authorities.

The information in this activity is provided to medical professionals for information purposes only. It is NOT to be disseminated to patients or for any other purpose. In particular, no information contained within this program is intended to be used for medical diagnosis or treatment.

The authors are exclusively responsible for the respective content. Accordingly, no responsibility is assumed by the contributing faculty, educational grant providers, and PCN and its affiliates associated with this activity for any injury and/or damage to persons or property as a matter of product liability, negligence or otherwise; or from any use or operation of any methods, products, instructions or ideas contained in the material herein. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without medically appropriate (1) evaluation of (a) their patients' conditions and (b) indications and possible contraindications, warnings, and adverse effects or dangers in use; (2) review of any applicable manufacturers' prescribing and other product information; (3) comparison with recommendations of recognized authorities; and (4) independent verification of diagnostic methods, therapeutic methods, results of research, and measurement of medical doses.

Content for this activity developed by Asante Communications


Method of Participation
To receive credit for this activity, the participant must read the CME information (including learning objectives and disclosures) and the article. Upon finishing the article, participant must complete the session post-test, evaluation, and all required personal information. To receive CME certificate, participant will need to pass the post-test with 70% accuracy or better. If participant receives less than 70%, participant should review the article and take the test again.

Post-test and Evaluation
After completing the CME article, participant must click on the Post-test button at the end of the article. After successful completion of the post-test, participant will be asked to fill out a program evaluation form and prompted to print the CME certificate. Participant can print certificate immediately or enter an email address to which certificate may be emailed.

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