A powerful intervention: general practitioners' use of sickness certification in depression

Macdonald, S. , Maxwell, M., Wilson, P., Smith, M., Whittaker, W., Sutton, M. and Morrison, J. (2012) A powerful intervention: general practitioners' use of sickness certification in depression. BMC Family Practice, 13(1), p. 82. (doi: 10.1186/1471-2296-13-82)

Abstract

<b>Background</b> Depression is frequently cited as the reason for sickness absence, and it is estimated that sickness certificates are issued in one third of consultations for depression. Previous research has considered GP views of sickness certification but not specifically in relation to depression. This study aimed to explore GPs views of sickness certification in relation to depression.<p></p> <b>Methods</b> A purposive sample of GP practices across Scotland was selected to reflect variations in levels of incapacity claimants and antidepressant prescribing. Qualitative interviews were carried out between 2008 and 2009.<p></p> <b>Results</b> A total of 30 GPs were interviewed. A number of common themes emerged including the perceived importance of GP advocacy on behalf of their patients, the tensions between stakeholders involved in the sickness certification system, the need to respond flexibly to patients who present with depression and the therapeutic nature of time away from work as well as the benefits of work. GPs reported that most patients with depression returned to work after a short period of absence and that it was often difficult to predict which patients would struggle to return to work.<p></p> <b>Conclusions</b> GPs reported that dealing with sickness certification and depression presents distinct challenges. Sickness certificates are often viewed as powerful interventions, the effectiveness of time away from work for those with depression should be subject to robust enquiry.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Wilson, Prof Philip and Maxwell, Dr Margaret and Morrison, Professor Jill and Smith, Dr Michael and Macdonald, Professor Sara
• Authors: Macdonald, S., Maxwell, M., Wilson, P., Smith, M., Whittaker, W., Sutton, M., and Morrison, J.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care
• Journal Name: BMC Family Practice
• Publisher: BioMed Central
• ISSN: 1471-2296
• Published Online: 09 August 2012
• Copyright Holders: Copyright © 2012 BioMed Central
• First Published: First published in BMC Family Practce 13(1):82
• Publisher Policy: Reproduced in accordance with the copyright policy of the publisher