Training GP's to use a minimal intervention for stress-related mental disorders with sick leave (MISS): Effects on performance: Results of the MISS project; a cluster-randomised controlled trial [ISRCTN43779641]

Objective - To study the effects of a brief patient-stress management training on the performance of general practitioners (GPs). Methods - After training in the Minimal Intervention for Stress-related mental disorders with Sick leave (MISS), the performance of 24 GPs was compared with the usual care provided by 22 GPs. Outcome measures in this intervention were: assignment of a diagnosis, taking an activating approach and monitoring the symptoms. Results - Twenty-three GPs completed the training. Outcomes showed that the training added to a psychosocial diagnosis. Other skills (using a questionnaire to make a diagnosis, handing out information leaflets and monitoring the symptoms) were to some extent improved by the training. Conclusion - The result indicates limited adherence of GPs to the MISS. Only a few components of the training were actually applied after the training, and there is still ample room for improvement. Practice implications - More than the current 11 h of training are probably needed to change the behaviour of GPs in general. Within educational programmes more attention should be given to the implementation of new behaviour, particularly when it concerns the treatment of patients with stress-related problem