Effectiveness and cost effectiveness of counselling in primary care

Clinical effectiveness and cost effectiveness of individual mental health workers colocated within primary care practices: a systematic literature review

“…9 18 39 40 There is a study that suggests that the intervention does not lead to increased costs, but this had a small sample size. 9 One area where there is agreement between studies, concordant with the findings of this review, is in referral changes associated with MHW integration. Decreases in the frequency of referrals to mental health specialists are well demonstrated in similar studies focused on both specific MHWs 9 18 and MHWs in general.…”

“…Integration of mental health practitioners has been devised as a solution to this problem as it is hypothesised that this could lead to reductions in resource utilisation and in health service utilisation, including fewer referrals to mental health specialists, fewer GP consultations and reduced drug prescriptions. However, this study and others assessing the overall resource utilisation of the intervention suggest that it is in fact associated with increased cost 9 18 39 40. There is a study that suggests that the intervention does not lead to increased costs, but this had a small sample size 9…”

“…However, this study and others assessing the overall resource utilisation of the intervention suggest that it is in fact associated with increased cost 9 18 39 40. There is a study that suggests that the intervention does not lead to increased costs, but this had a small sample size 9…”

Clinical effectiveness and cost effectiveness of individual mental health workers colocated within primary care practices: a systematic literature review

“…9 18 39 40 There is a study that suggests that the intervention does not lead to increased costs, but this had a small sample size. 9 One area where there is agreement between studies, concordant with the findings of this review, is in referral changes associated with MHW integration. Decreases in the frequency of referrals to mental health specialists are well demonstrated in similar studies focused on both specific MHWs 9 18 and MHWs in general.…”

“…Integration of mental health practitioners has been devised as a solution to this problem as it is hypothesised that this could lead to reductions in resource utilisation and in health service utilisation, including fewer referrals to mental health specialists, fewer GP consultations and reduced drug prescriptions. However, this study and others assessing the overall resource utilisation of the intervention suggest that it is in fact associated with increased cost 9 18 39 40. There is a study that suggests that the intervention does not lead to increased costs, but this had a small sample size 9…”

“…However, this study and others assessing the overall resource utilisation of the intervention suggest that it is in fact associated with increased cost 9 18 39 40. There is a study that suggests that the intervention does not lead to increased costs, but this had a small sample size 9…”

The Effect of Integrative Counselling on Psychological Well-Being in Adult Patients with Cancer: A Mixed Methods Study

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Meta‐analysis of standardised mean differences from randomised trials with treatment‐related clustering associated with care providers

“…Using our proposed metric for our example of counselling in primary care, we found that the impact of treatment‐related clustering on the pooled SMD estimate, and its standard error was not important. Our sensitivity analyses for the meta‐analysis published by Bower and Rowland did not change their conclusions. In hindsight, the reasons for this are obvious: (i) the ICC and the cluster sizes were both small, so the variance inflation factors were small; (ii) a larger number of patients were allocated to counselling compared with no counselling; and (iii) the between‐trial heterogeneity in the treatment effect was dominant.…”

Clinical effectiveness and cost effectiveness of individual mental health workers colocated within primary care practices: a systematic literature review

“…9 18 39 40 There is a study that suggests that the intervention does not lead to increased costs, but this had a small sample size. 9 One area where there is agreement between studies, concordant with the findings of this review, is in referral changes associated with MHW integration. Decreases in the frequency of referrals to mental health specialists are well demonstrated in similar studies focused on both specific MHWs 9 18 and MHWs in general.…”

“…Integration of mental health practitioners has been devised as a solution to this problem as it is hypothesised that this could lead to reductions in resource utilisation and in health service utilisation, including fewer referrals to mental health specialists, fewer GP consultations and reduced drug prescriptions. However, this study and others assessing the overall resource utilisation of the intervention suggest that it is in fact associated with increased cost 9 18 39 40. There is a study that suggests that the intervention does not lead to increased costs, but this had a small sample size 9…”

“…However, this study and others assessing the overall resource utilisation of the intervention suggest that it is in fact associated with increased cost 9 18 39 40. There is a study that suggests that the intervention does not lead to increased costs, but this had a small sample size 9…”

The Effect of Integrative Counselling on Psychological Well-Being in Adult Patients with Cancer: A Mixed Methods Study

“……”

Meta‐analysis of standardised mean differences from randomised trials with treatment‐related clustering associated with care providers

“…Using our proposed metric for our example of counselling in primary care, we found that the impact of treatment‐related clustering on the pooled SMD estimate, and its standard error was not important. Our sensitivity analyses for the meta‐analysis published by Bower and Rowland did not change their conclusions. In hindsight, the reasons for this are obvious: (i) the ICC and the cluster sizes were both small, so the variance inflation factors were small; (ii) a larger number of patients were allocated to counselling compared with no counselling; and (iii) the between‐trial heterogeneity in the treatment effect was dominant.…”

Clinical effectiveness and cost effectiveness of individual mental health workers colocated within primary care practices: a systematic literature review

“…9 18 39 40 There is a study that suggests that the intervention does not lead to increased costs, but this had a small sample size. 9 One area where there is agreement between studies, concordant with the findings of this review, is in referral changes associated with MHW integration. Decreases in the frequency of referrals to mental health specialists are well demonstrated in similar studies focused on both specific MHWs 9 18 and MHWs in general.…”

“…Integration of mental health practitioners has been devised as a solution to this problem as it is hypothesised that this could lead to reductions in resource utilisation and in health service utilisation, including fewer referrals to mental health specialists, fewer GP consultations and reduced drug prescriptions. However, this study and others assessing the overall resource utilisation of the intervention suggest that it is in fact associated with increased cost 9 18 39 40. There is a study that suggests that the intervention does not lead to increased costs, but this had a small sample size 9…”

“…However, this study and others assessing the overall resource utilisation of the intervention suggest that it is in fact associated with increased cost 9 18 39 40. There is a study that suggests that the intervention does not lead to increased costs, but this had a small sample size 9…”

The Effect of Integrative Counselling on Psychological Well-Being in Adult Patients with Cancer: A Mixed Methods Study

“……”

Meta‐analysis of standardised mean differences from randomised trials with treatment‐related clustering associated with care providers

“…Using our proposed metric for our example of counselling in primary care, we found that the impact of treatment‐related clustering on the pooled SMD estimate, and its standard error was not important. Our sensitivity analyses for the meta‐analysis published by Bower and Rowland did not change their conclusions. In hindsight, the reasons for this are obvious: (i) the ICC and the cluster sizes were both small, so the variance inflation factors were small; (ii) a larger number of patients were allocated to counselling compared with no counselling; and (iii) the between‐trial heterogeneity in the treatment effect was dominant.…”