Anxiety Treatment in Primary Care Settings: The Good and The Bad

anxietyRegarding primary physician care for anxiety disorders, research shows mixed results.

Brown University psychiatry researchers have discovered that seven out of 10 primary care patients who present with an anxiety disorder receive adequate medicine and psychotherapy.[1] However, the successful reduction of anxiety often takes primary care patients years to accomplish, while it doesn’t have to.1

A study of 534 patients revealed that 28 percent were receiving potentially adequate medication, psychotherapy, or both when they began their care from one of 15 primary care sites in New England.1 At a five-year follow-up, 69 percent received either or both appropriate medicine or psychosocial treatment, such as cognitive-behavioral therapy.1 This increase in treatment was positive.

While most patients did receive good treatment, it wasn’t sustained for long periods of time and cognitive-behavioral therapy was rarely continued.1 Also, ethno-racial minorities were less likely to receive good care.1

Anxiety disorders are often chronic and primary care providers typically have an ongoing relationship with patients; however, many past studies have shown treatment for anxiety to be poor.1 This is due to the fact that past studies have only focused on one single point in time, while this one looked at a five-year period, making it more accurate.1

Primary care providers were found to have prescribed evidence-based medicine that has known efficacy when taken at an adequate dose for enough time.1 Also, cognitive-behavioral therapy has much empirical support regarding treatment for anxiety disorders.1

Still, over the course of five years, although many patients did receive adequate care, many were less likely to have received it.1 For example, minorities were 50 percent less likely to receive adequate treatment, while people of any race or ethnicity with a college education were twice as likely to receive adequate care.1

Patients may take a while to receive care as primary care physicians often employ a strategy called “watchful waiting” to see if symptoms will improve on their own.1 Also, as many psychiatric practices are often full with long waiting periods, referrals don’t always pan out.1 However, patients with severe anxiety were more likely to receive the care they needed the soonest.1

Overall, although many did receive the care they needed and showed improvements, there were still patients who were falling through the cracks and suffering because of it.1

[1] Nauert, R. (2013). Primary Care Treatment of Anxiety is Adequate, But Problems Persist. Psych Central. Retrieved on November 8, 2013, from http://psychcentral.com/news/2013/11/08/primary-care-treatment-of-anxiety-is-adequate-but-problems-persist/61755.html

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