The update of the treatment manual "Management of generalized anxiety disorder and panic disorder (with or without agoraphobia) in family medicine" was initiated because more than five years had passed since the publication of the original manual in 2014. The procedure for updating treatment manuals is written in the "Estonian manual for the preparation of treatment manuals" (2020). At the first meeting, the working group of the treatment guideline reviewed the questions raised during the preparation of the original guideline and found that some clinical questions concerning the pharmacological treatment of generalized anxiety disorder may have added evidence over time, which may change the originally given recommendation. They also wanted to review the recommendations regarding healthcare management given in the original guide. Based on the audit of the Estonian Health Insurance Fund (1) published in 2018, it was revealed that the diagnosis, treatment and monitoring of anxiety disorders varies in Estonia. One of the observations was the incomplete completion of treatment documentation, which made it difficult to assess and understand the justification of various actions and the doctor's thinking in the treatment of a patient with an anxiety disorder.

The audit showed that most of the patients were prescribed treatment at the initial visit:

a third were recommended psychotherapy, a third were prescribed antidepressant treatment, and a third were treated with a benzodiazepine. However, recommendations on self-help techniques are mostly not shared. The auditors recommended developing evidence-based material on self-help techniques that can be given to the patient (with him). The audit also noted that sufficient opportunities must be ensured to refer patients to psychotherapy. Mental health nurses are needed, who would help monitor and support patients. In order to ensure the best treatment for the patient, it is important that the family doctor can easily consult with a psychiatrist during the treatment process. The purpose of updating the treatment manual was to ensure contemporary evidence-based treatment of patients with anxiety disorders in family medicine care in Estonia. When updating the guide, the focus was on the (re)opened questions of the working group and the bottlenecks in the treatment of patients with anxiety disorders revealed by the audit.