To evaluate the effects of a multifactor process of implementation of the e-CPG MD, analyzing its use and the key clinical outcomes.

A cluster randomized clinical trial was performed in 10 primary care centers (PCC) in Barcelona. In five of ten centers a multifaceted implementation process of the e-CPG-MD was developed during 6 month. The others five PCCs received only an usual diffusion. The multifaceted process includes an establishment of local implementation teams, an interactive training program, regular feedback audits, educational outreach visits and periodic reminders.

At six month, a greater proportion of new MD patients from active PCCs were included in the e- CPG-DEP (4.1% + 3.1% vs. 52.7% + 7.3%, p < 0.001); the incidence of MD diagnostics of Major Depression increased significantly (rate quotient = 1.56, p < 0.001) and the proportion of cases with moderate and severe MD too (13.6% vs 41.1%, p = 0.002).

A multifaceted implementation method of an e-CPG-MD increased significantly its uses, the registered incidence of MD and improved the capacity of recognizing severity. Further analysis is necessary in order to determine the impact on clinical outcomes.

The authors have not supplied their declaration of competing interest.