Impact of telephone delivered case-management on the effectiveness of collaborative care for depression and anti-depressant use: A systematic review and meta-regression.


Journal

PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081

Informations de publication

Date de publication:
2019
Historique:
received: 07 03 2019
accepted: 21 05 2019
entrez: 15 6 2019
pubmed: 15 6 2019
medline: 11 2 2020
Statut: epublish

Résumé

The health service delivery framework collaborative care is an effective intervention for depression. However, uncertainties remain about how to optimise its delivery at scale. Structured case management is a core component of collaborative care; its delivery via the telephone may improve access. To examine using meta-regression if telephone delivered case management diminishes the clinical effectiveness of collaborative care on depressive symptoms and anti-depressant use relative to face-to-face delivery methods. Randomised controlled trials were eligible if they included collaborative care interventions for adults with depression identified using self-report measures or diagnostic interviews and reported depression outcomes. Sociodemographics, intervention characteristics, depressive symptoms, and anti-depressant use were extracted. Random effects univariable and multivariable meta-regression analyses were used to examine the moderating effect of telephone delivered case-management on outcomes. Ninety-four trials were identified comprising of 103 comparisons across 24, 132 participants with depression outcomes and 67 comparisons from 15,367 participants with anti-depressant use outcomes. Telephone delivered case management did not diminish the effects of collaborative care on depressive symptoms (β = -0.01, 95% CI -0.12 to 0.10; p = 0.86). Telephone delivered case management decreased anti-depressant medication use (relative risk 0.76, 95% CI 0.63 to 0.92; p = 0.005); this effect remained when assessed simultaneously alongside other study-level moderators of collaborative care. Using remote platforms such as the telephone to deliver case management may be a feasible way to implement collaborative care with no loss of effectiveness on depressive symptoms. However, adherence to anti-depressant medication may decrease when telephone case management is used.

Sections du résumé

BACKGROUND
The health service delivery framework collaborative care is an effective intervention for depression. However, uncertainties remain about how to optimise its delivery at scale. Structured case management is a core component of collaborative care; its delivery via the telephone may improve access.
AIMS
To examine using meta-regression if telephone delivered case management diminishes the clinical effectiveness of collaborative care on depressive symptoms and anti-depressant use relative to face-to-face delivery methods.
METHODS
Randomised controlled trials were eligible if they included collaborative care interventions for adults with depression identified using self-report measures or diagnostic interviews and reported depression outcomes. Sociodemographics, intervention characteristics, depressive symptoms, and anti-depressant use were extracted. Random effects univariable and multivariable meta-regression analyses were used to examine the moderating effect of telephone delivered case-management on outcomes.
RESULTS
Ninety-four trials were identified comprising of 103 comparisons across 24, 132 participants with depression outcomes and 67 comparisons from 15,367 participants with anti-depressant use outcomes. Telephone delivered case management did not diminish the effects of collaborative care on depressive symptoms (β = -0.01, 95% CI -0.12 to 0.10; p = 0.86). Telephone delivered case management decreased anti-depressant medication use (relative risk 0.76, 95% CI 0.63 to 0.92; p = 0.005); this effect remained when assessed simultaneously alongside other study-level moderators of collaborative care.
CONCLUSION
Using remote platforms such as the telephone to deliver case management may be a feasible way to implement collaborative care with no loss of effectiveness on depressive symptoms. However, adherence to anti-depressant medication may decrease when telephone case management is used.

Identifiants

pubmed: 31199827
doi: 10.1371/journal.pone.0217948
pii: PONE-D-19-06417
pmc: PMC6568394
doi:

Substances chimiques

Antidepressive Agents 0

Types de publication

Comparative Study Journal Article Meta-Analysis Research Support, Non-U.S. Gov't Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

e0217948

Subventions

Organisme : Medical Research Council
ID : G0701013
Pays : United Kingdom
Organisme : Department of Health
ID : RCF_R10_PC
Pays : United Kingdom

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

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Auteurs

Joanna L Hudson (JL)

King's College London, Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, De Crespigny Park, London, United Kingdom.

Peter Bower (P)

NIHR School for Primary Care Research, Centre for Primary Care and Centre for Health Informatics, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom.

Evangelos Kontopantelis (E)

NIHR School for Primary Care Research, Centre for Primary Care and Centre for Health Informatics, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom.

Penny Bee (P)

Division of Nursing, Midwifery & Social Work, University of Manchester, Manchester, United Kingdom.

Janine Archer (J)

School of Health and Society, University of Salford, Salford, United Kingdom.

Rose Clarke (R)

Sheffield NHS Improving Access to Psychological Therapies (IAPT), St George's Community Health Centre, Sheffield, United Kingdom.

Andrew S Moriarty (AS)

Department of Health Sciences and Hull York Medical School, University of York, York, United Kingdom.

David A Richards (DA)

Institute of Health Research, University of Exeter College of Medicine and Health, University of Exeter, Exeter, United Kingdom.

Simon Gilbody (S)

Department of Health Sciences and Hull York Medical School, University of York, York, United Kingdom.

Karina Lovell (K)

Division of Nursing, Midwifery & Social Work, University of Manchester, Manchester, United Kingdom.

Chris Dickens (C)

Institute of Health Research, University of Exeter College of Medicine and Health, University of Exeter, Exeter, United Kingdom.

Linda Gask (L)

NIHR School for Primary Care Research, Centre for Primary Care and Centre for Health Informatics, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom.

Waquas Waheed (W)

NIHR School for Primary Care Research, Centre for Primary Care and Centre for Health Informatics, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom.

Peter A Coventry (PA)

Department for Health Sciences and Centre for Reviews and Dissemination, University of York, York, United Kingdom.

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