A provincial adaptation of clinical practice guidelines for depression in primary care: a case illustration of the ADAPTE method Pasquale Roberge PhD, 1 Louise Fournier PhD, 2 Hélène Brouillet MPs, 3 André Delorme MD, 4 Clément Beaucage MD, 5 Rodrigue Côté BSc, 6 Pierre Demers BSc, 7 Michel Gervais MD, 4 France Laflamme MSc, 8 Louise Latulippe RN, 4 André Marchand PhD, 9 Simon Patry MD, 10 Suzanne Pelchat MD, 11 Martin D. Provencher PhD, 12 Jean-Rémy Provost MSc, 13 David Robitaille MD 14 and Anne-Marie Cloutier MSc 15 1 Professor, Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, Sherbrooke, Canada 2 Professor, Research Centre of the Centre hospitalier de l’Université de Montréal (CRCHUM), Montréal, Canada 3 Knowledge Broker, Institut national de santé publique du Québec, Montréal, Canada 4 Psychiatrist, Director of mental health, Michel Gervais is Psychiatrist, Louise Latulippe is Research and planning officer, Ministère de la Santé et des Services sociaux du Québec, Québec, Canada 5 Community Health Physician, Direction régionale de la santé publique, Agence de la santé et des services sociaux de la Capitale-Nationale, Québec, Canada 6 Assistant Director of Child and Youth Mental Health Services, Centre de santé et de services sociaux de la Vieille-Capitale, Québec, Canada 7 Chief Officer of Adult Mental Health Services, Centre de santé et de services sociaux du Sud-Ouest-Verdun, Montréal, Canada 8 Nurse Consultant, Ordre des infirmières et infirmiers du Québec, Montréal, Canada 9 Professor, Department of Psychology, Université du Québec à Montréal, Montréal, Canada 10 Psychiatrist, Institut universitaire en santé mentale de Québec, Québec, Canada 11 Family Physician, Centre de santé et de services sociaux de Québec Nord, Québec, Canada 12 Professor, School of Psychology, Université Laval, Québec, Canada 13 General Director, Revivre – Quebec Anxiety, Depressive and Bipolar Disorder Support Association, Montréal, Canada 14 Psychiatrist, Centre de santé et de services sociaux Pierre-Boucher, Longueuil, Canada 15 Reserch Officer, Research Centre of the Centre hospitalier de l’Université de Montréal (CRCHUM), Montréal, Canada Keywords ADAPTE methodology, clinical practice guidelines, dissemination, major depressive disorder Correspondence Prof Pasquale Roberge Département de médecine de famille et de médecine d’urgence Université de Sherbrooke – Groupe de recherche PRIMUS 3001, 12 e avenue Nord Sherbrooke, Québec J1H 5N4 Canada E-mail: pasquale.roberge@usherbrooke.ca Accepted for publication: 16 May 2015 doi:10.1111/jep.12404 Abstract Rationale, aims and objectives Mental health services for patients with a major depres- sive disorder are commonly delivered by primary care. To support the uptake of clinical practice guidelines in primary care, we developed and disseminated a practice protocol for depression tailored for a multidisciplinary audience of primary mental health care providers with the ADAPTE methodology. The research questions addressed in this study aimed at examining the experience of the development process of a mental health practice protocol in terms of adaptation, facilitation and implementation. Methods We present a descriptive case study of the development and implementation of a practice protocol for major depressive disorder for primary mental health care in the organizational and cultural context of the province of Québec (Canada), following the steps of the ADAPTE methodology. An expert committee composed of general practitioners, mental health specialists, health care administrators and decision makers at regional and provincial levels participated in the protocol development process. Results The practice protocol was based on two clinical practice guidelines: the NICE guideline on the treatment and management of depression in adults (2009, 2010) and the Canadian Network for Mood and Anxiety Treatments clinical guidelines for the manage- ment of major depressive disorder in adults (2009). A stepped care model was embedded in the protocol to facilitate the implementation of clinical recommendations in primary mental health care. A multifaceted dissemination strategy was used to support the uptake of the protocol recommendations in clinical practice. Conclusions The ADAPTE methodology provided structure, rigour and efficiency to the trans-contextual adaptation of guideline recommendations. We will share the challenges associated with the adaptation of clinical recommendations and organizational strategies for a mental health guideline, and the dissemination of the practice protocol in primary care. Journal of Evaluation in Clinical Practice ISSN 1365-2753 Journal of Evaluation in Clinical Practice (2015) © 2015 John Wiley & Sons, Ltd. 1