Does collaborative care improve social functioning in adults with depression? The application of the WHO ICF framework and meta-analysis of outcomes

Hudson, Joanna; Bower, Peter; Archer, Janine; Coventry, Peter

doi:10.1016/j.jad.2015.09.034

Cited by 16 publications

(14 citation statements)

References 33 publications

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“…The results of that search were published as a Cochrane Review [6]. The search was updated using the CENTRAL database in December 2013 and incorporated in a previous meta-regression [19] and meta-analysis [21]. For this review we updated this search using the CENTRAL database in October 2016 and May 2017.…”

Section: Methodsmentioning

confidence: 99%

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

et al. 2019

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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.

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Section: Methodsmentioning

confidence: 99%

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

et al. 2019

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“…Estos resultados son comparables con los hallazgos del estudio realizado en la ciudad de Cali (Colombia), en el que se identificó mayor probabilidad de carga de discapacidad en población con tmg con presencia de síntomas depresivos (or = 4,47) (35). Al respecto, se ha establecido una relación entre los síntomas depresivos, el funcionamiento físico y la participación social, lo que influye directamente en la capacidad de disfrute y mantenimiento de hábitos y rutinas (47). Si una persona se encuentra con sintomatología actual, se incrementa la carga de discapacidad, y ello genera cambios en el desempeño de actividades con propósito en ámbitos familiares y comunitarios, especialmente si se trata de población con síntomas refractarios (48,49).…”

Section: Discussionunclassified

Evaluación de la discapacidad en población con trastornos mentales graves atendida en el Distrito Metropolitano de Quito (Ecuador)

et al. 2021

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Introducción: en Ecuador existen parámetros de calificación de discapacidad basados en la Clasificación Internacional del Funcionamiento de la Discapacidad y la Salud, pero los avances en investigación en el ámbito de la psiquiatría y la salud mental aún son escasos. Se empleó la Escala de Evaluación de Discapacidad de la Organización Mundial de la Salud para determinar el grado de discapacidad en población consultante. Materiales y métodos: estudio observacional, de corte transversal y correlacional. Usando un muestreo por conveniencia, se recogió información sobre discapacidad en una muestra de 297 adultos con trastornos mentales graves en contacto con servicios ambulatorios de psiquiatría. Se estimó un modelo de regresión lineal que determinó el aporte de variables sociodemográficas, clínicas y sociales. Resultados: el 89.2 % de la muestra presentó algún grado de discapacidad. El modelo multivariado final para el total de la muestra incluyó las variables explicativas edad (β = −0.234), escolaridad (β = −0.552), ser pensionado (β = 39.44), presencia de episodio depresivo actual (β = 21.654) y tener cuidador (β = 9.574), que explican el 37.46 % de la discapacidad de las personas con trastornos mentales graves atendidas en servicios de psiquiatría y salud mental en Quito. Conclusión: la discapacidad en personas con trastornos mentales graves que están en contacto con servicios de salud de Quito involucra cambios en el desempeño de actividades en escenarios familiares y comunitarios. Se identificó una proporción de discapacidad moderada y severa que demanda respuestas institucionales que incluyan el acompañamiento de cuidadores y aborden barreras actitudinales.

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“…This includes capabilities to leverage the EHR for remote and point-of-care electronic patient-reported outcomes (ePROs). EHR-driven approaches that include patient-care strategies with aligned symptom-specific goals, support for self-management training, and decision support for medication changes have considerable potential to improve the management of symptoms in patients with cancer [22][23][24][25][26][27][28][29][30][31][32][33][34][35]. Here we describe a randomized study to assess such an EHR-driven approach.…”

Section: Background and Rationale {6a}mentioning

confidence: 99%

Pragmatic cluster randomized trial to evaluate effectiveness and implementation of enhanced EHR-facilitated cancer symptom control (E2C2)

Rutten

Ruddy

Chlan

et al. 2020

Trials

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Background: The prevalence of inadequate symptom control among cancer patients is quite high despite the availability of definitive care guidelines and accurate and efficient assessment tools. Methods: We will conduct a hybrid type 2 stepped wedge pragmatic cluster randomized clinical trial to evaluate a guideline-informed enhanced, electronic health record (EHR)-facilitated cancer symptom control (E2C2) care model. Teams of clinicians at five hospitals that care for patients with various cancers will be randomly assigned in steps to the E2C2 intervention. The E2C2 intervention will have two levels of care: level 1 will offer low-touch, automated self-management support for patients reporting moderate sleep disturbance, pain, anxiety, depression, and energy deficit symptoms or limitations in physical function (or both). Level 2 will offer nurse-managed collaborative care for patients reporting more intense (severe) symptoms or functional limitations (or both). By surveying and interviewing clinical staff, we will also evaluate whether the use of a multifaceted, evidence-based implementation strategy to support adoption and use of the E2C2 technologies improves patient and clinical outcomes. Finally, we will conduct a mixed methods evaluation to identify disparities in the adoption and implementation of the E2C2 intervention among elderly and rural-dwelling patients with cancer. Discussion: The E2C2 intervention offers a pragmatic, scalable approach to delivering guideline-based symptom and function management for cancer patients. Since discrete EHR-imbedded algorithms drive defining aspects of the intervention, the approach can be efficiently disseminated and updated by specifying and modifying these centralized EHR algorithms.

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Does collaborative care improve social functioning in adults with depression? The application of the WHO ICF framework and meta-analysis of outcomes

Abstract: Collaborative care improves social functioning but the mechanisms through which this occurs are unknown. Future depression interventions need to consider a person's degree of social function equally alongside their depressive symptoms.

Cited by 16 publications

References 33 publications

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

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

Evaluación de la discapacidad en población con trastornos mentales graves atendida en el Distrito Metropolitano de Quito (Ecuador)

Pragmatic cluster randomized trial to evaluate effectiveness and implementation of enhanced EHR-facilitated cancer symptom control (E2C2)

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