Healthcare practice is becoming more and more complicated due to many different factors. One of the most relevant factors is the exponential increase of scientific information.

To make clinical decisions that are adequate, safe and effective, practitioners need to devote a lot of effort in continuously updating their knowledge.

In 2003, the Interterritorial Council of the Spanish SNS created the GuiaSalud Project whose final aim is to improve clinical decision-making based on scientific evidence, via training activities and the configuration of a registry of Clinical Practice Guidelines (CPG). Since then, the GuiaSalud project has assessed dozens of CPGs in agreement with explicit criteria stipulated by its scientific committee. It has registered them and has disseminated them over the Internet.

At the beginning of 2006, the G.D. of the Quality Agency of the National Health System prepared the Quality Plan for the National Health System, which was divided into in 12 strategies.

The purpose of this Plan is to increase the cohesion of the National Health System and help guarantee maximum quality health care for all citizens regardless of their place of residence.

As part of the Plan, different agencies and expert groups in prevalent pathologies related to health strategies were entrusted with the preparation of eight CPGs. This depression guide is the fruit of this assignment.

The definition of a common methodology to prepare the CPG for the SNS was also requested and this has been prepared as a collective effort of consensus and coordination among the Spanish CPG expert groups. This methodology was used as the basis to prepare this Depression guide and the other CPGs driven by the Quality Plan.

The GuiaSalud Project was renewed in 2007 and the Clinical Practice Guideline Library was created. This project developed into the preparation of the CPGs and included other Evidence-Based Medicine services and products. It also aims to favour the implementation and assessment of the use of CPGs in the National Health System.

Depression in adults represents an important health problem due to its high prevalence, to the handicaps and changes in quality of life it generates as well as its enormous economic impact. It is also managed in a variety of ways, with different therapeutic, referral and follow-through approaches.

This clinical practice guideline addresses depression in adults and it is the result of the work of a large group of professionals belonging to different disciplines who provide health care for patients with depression. The members of the drafting group have spent many hours preparing the recommendations which will undoubtedly help improve the health care provided both in primary and in specialised care. The scientific societies involved and patients’ associations directly involved in this health problem have collaborated in the review process of the guideline.

Answers to many of the questions that arise when caring for an adult patient with depression will be found in this guideline. These questions are given in the form of systematically prepared recommendations and with the best available evidence. We hope that it will also result in higher quality care for these patients and their families, which is the goal we pursue.

Dr. Alberto Infante Campos.
General Department of the SNS Quality Agency