Therapiealgorithmen in der Depressionsbehandlung — Das Berliner Algorithmusprojekt

Zusammenfassung

Therapieresistenz stellt in der Depressionsbehandlung nach wie vor ein großes Problem dar. Als ein Mittel zur Optimierung der Behandlung depressiver Erkrankungen gelten Therapiealgorithmen, bei denen es sich um explizite und systematisierte Behandlungsprotokolle handelt. Sie enthalten standardisierte Handlungsanweisungen für therapeutische Entscheidungen, die Diagnosestellung, Definition des Therapieziels, Definition der Kontrollinstrumente und Kontrolle des Therapieerfolges in einem zeitlich festgelegten Rahmen. Ziel des mehrphasigen Berliner Algorithmusprojekt ist die Evaluierung algorithmusgestützter Depressionsbehandlung im Vergleich zur üblichen Therapie nach freier Arztentscheidung. Darüber hinaus werden verschiedene Folgestrategien bei Patienten, die nicht adäquat auf eine initiale antidepressive Monotherapie angesprochen haben, miteinander verglichen. Die vorläufigen Ergebnisse dieser und weiterer Algorithmusstudien zeigen den Nutzen systematischer Therapiealgorithmen in der Depressionsbehandlung in Bezug auf das Therapieergebnis, die Qualität der Behandlung, gesundheitsökonomische Parameter und die Zufriedenheit der Patienten.

Summary

Treatment resistance remains a major clinical problem in the therapy of major depression. Algorithms are explicit and systematic treatment protocols. They are considered as key instruments in optimizing the therapy of depressive disorders. Treatment algorithms base on standardized procedures for medical decision making, diagnostic consideration, definition of the aim of treatments, definition of evaluation instruments and evaluation of treatment response, all of which within a predefined timeframe. The multiphasic German Algorithm Project („Berliner Algorithmusprojekt”) aims at comparing algorithm guided treatment with treatment as usual. Furthermore it compares different “second-step-strategies” in case of non-response to an initial antidepressant monotherapy. The preliminary results of this ongoing project and other algorithm studies show the benefit of treatment algorithms for treatment outcome, therapy quality, cost-effectiveness and patients’ satisfaction.

Schlüsselwörter

Therapiealgorithmus - Depression - Therapieresistenz - Berliner Algorithmusprojekt

Keywords

treatment algorithms - depression - treatment resistance - German Algorithm Project

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