Involving service users in the evaluation and redesign of primary care services for depression: A qualitative study

Aim: To understand the experiences, expectations and needs of service users with mild to moderate depression, and to use these to inform the design and redesign of local services in primary care. Design of study: Needs assessment using in-depth semi-structured qualitative interviews. Setting: A single general practice in eastern England. Methods: Nine patients with depression were identified from the practice register using purposeful sampling and interviewed by a practice nurse who had not previously provided any care to them. Ritchie and Spencer's Framework approach was used to analyse the qualitative data. Results: Participants welcomed the opportunity to provide feedback on their experiences. They told many positive stories which affirmed the overall accessibility and acceptability of the existing service. They reported symptoms that were distressing and difficult to live with, even when their depression was classified by health professionals as 'mild'. Participants considered they had good access to care. Despite this, many participants identified gaps in the current service such as access to information and concerns about discontinuing medication in the future. Conclusion: In-depth interviews with patients with depression are a feasible and acceptable way of identifying service gaps and enabling users to contribute to service evaluation and redesign. © 2005 Librapharm Limited