Agnieszka Leszczynska: Primary care physicians will be able to diagnose depression more easily

Within the framework of coordinated care, the primary care physician collaborates with specialist physicians, a primary care nurse, and a nutritionist. In terms of what it deals with, it is prevention, treatment, diagnosis and patient education about selected diseases in the fields of cardiology, diabetology, endocrinology or pulmonology. Does it really cover all the conditions that patients come to primary care with?

I am very happy that such a project as coordinated care has been created. It is absolutely necessary because we have diseases of civilization. There are almost 40 million Poles, and there are very few specialists. It's a small prole in the sea of patient needs. So I'm glad that the primary care physician will deal with these diseases, will have the support of specialists and will already be able to help the patient at this basic level. We had to start somewhere, so we just started with pulmonology, diabetology or endocrinology. Instead, it is necessary to go further and see what other diseases are consuming our society as a whole. One such disease is depression. It is a disease of civilization in the twenty-first century, and the last few years have not helped us, because first there was the first pandemic, second there was the war in Ukraine, and then the financial turmoil. The depressive component is very large and these people need to be helped, taken care of. On the other hand - brain diseases are the least recognized diseases. They are also the most difficult, because even a patient who goes to a specialist and gets the first prescription for an antidepressant, will only get a response to that treatment in 40 percent of cases. It's very individual, and not always a particular drug or a particular therapy is a hit. It takes a great deal of expertise, hence psychiatry as the next step in coordinated care seems essential.

Of course, coordinated care still applies to 35 percent of primary care facilities. It's expanding all the time, and we shouldn't do it too fast.

The social problem and the medical problem are fueled by the situation around us. Reform of adult and child and adolescent psychiatry seems to be the answer to these challenges. To what extent is this really an effective attempt to solve these problems, especially with the ongoing medical staffing problem?

This is a very hard question. I think we are at the beginning of this road. It's not a process that is already complete and that can automatically pass to GPs. Our company, as a leader in the field of depression, is trying not only to promote its drugs and sell them, but also to help doctors, especially GPs in the diagnosis and treatment of depression. I can proudly announce, and I already announced it in Karpacz in September, that we are working on a special application. Now we have practically finished working on it and are implementing it for testing. It is an educational platform. It contains two tests: PHQ-2 and PHQ-9. These will allow the GP, as part of the scaling up, to diagnose whether the patient actually has depression. Later, already within the framework of the whole profile, that is, regarding age, what are the characteristics of anxiety or depressive behavior, the appropriate treatment can be selected, including dosage.

This is not a commercial action, we are not targeting the product or products we have in our portfolio. It's our contribution to digitalization, on the one hand, and on the other hand - to expand the knowledge of the general practitioner, so that literally within 10 minutes he can diagnose and better, more effectively select antidepressant treatment for a given patient. We prepared this application with two of the most important psychiatric centers: the Lodz center, headed by Professor Piotr Galecki, who is the national consultant for psychiatry, and the Krakow center, headed by Professor Dominika Dudek, who is the president of the Polish Psychiatric Association. The experts built the application to help the GP as much as possible.

There is no shortage of examples of how GP-patient collaboration with the support of new technologies actually works. We can say that this is such a new trend, which well worth implementing and worth it to find its place in the offer?

Patients also want this. Over the past 1.5 years, we have set up kiosks in primary care clinics where patients themselves, while waiting to see their GP, could take this short nine-question test and diagnose if they are okay, or if they have any problems with anxiety, insomnia, depression. More than 5,000 patients have already taken advantage of this. Unhappily, 70 percent have some sort of anxiety component.