Depression among elderly primary care patients is common. Of the older patients who visit a primary care clinic 5–10% has a depressive disorder [1, 2]. Depression causes suffering and is associated with serious disability, reduced quality of life and general functioning. The course of depression is often chronic or recurrent [3, 4]. Delivering effective treatments is of major importance for this group of patients.
Antidepressant drugs and some forms of psychotherapy are both considered to be evidence based therapies, as they were effective in older secondary care patients . Some forms of psychotherapy have also proved to be effective in midlife primary care patients , but research on older primary care populations is limited . Recently, it has been demonstrated that depression treatment for elderly primary care patients is effective, when a collaborative care model is used in which the primary care physician is supported by a mental health worker in carrying out guideline-driven depression care, including optimal drug therapy, intensively monitoring of drug use, and when indicated, delivering easily accessible evidence based forms of psychotherapy such as IPT or Problem Solving Therapy [8, 9]. However, it has consistently been found that the majority of depressed elderly patients in primary care are likely to pass undiagnosed and untreated, with negative mental and physical health consequences . If depression treatment is started, usually antidepressants are offered as first choice treatment. Psychotherapy may be indicated for patients who do not benefit from antidepressant drug treatment or who are sensitive to side-effects, but evidence based psychotherapy is mostly not available in primary care, and referrals to secondary care are frequently not completed by older patients . Apparently, evidence based psychotherapies have not found their way to general practice.
Interpersonal psychotherapy (IPT) seems to be a suitable form of psychotherapy to be delivered to older primary care patients. Its efficacy has been proved , and it has been studied both in older patients  and in mid life primary care patients . Furthermore, therapists with different therapeutic backgrounds can learn this therapy relatively easily . To explore the implementation potential of IPT, it is important to study uptake and satisfaction when this therapy is introduced into general practice.
In this paper we describe motivation and evaluation of patients, GPs and therapists as well as organizational barriers to introducing IPT for depressed elderly patients into general practice. We recorded these data while conducting a randomized controlled trial, because these data are only interesting when it has been demonstrated that the intervention is effective. This was not yet the case for IPT in elderly depressed primary care patients. In our effectiveness trial, IPT provided by mental health workers was compared with care as usual provided by the general practitioner (GP). The effectiveness results of our study have been detailed in a separate paper . At the end of this paper we integrate the effectiveness results with the findings described in the current paper and discuss whether there are grounds to support the dissemination of IPT for elderly patients in real-life general practice.