Effectiveness of a collaborative care intervention for managing major depression and chronic musculoskeletal pain in primary care: A cluster-randomised controlled trial

Aragonès, Enric; Rambla, Concepció; López-Cortacans, Germán; Tomé‐Pires, Catarina; Sánchez‐Rodríguez, Elisabet; Caballero, Antonia; Miró, Jordi

doi:10.1016/j.jad.2019.04.004

Cited by 33 publications

(46 citation statements)

References 38 publications

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“…The characteristics of included studies are presented in the Appendix A Table A3 and Table A4 . Of the 85 studies included in the review, 78 studies were RCTs [ 13 , 14 , 16 , 18 , 19 , 20 , 22 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80...…”

Section: Resultsmentioning

confidence: 99%

“…Meta-analysis of thirty-one studies [ 13 , 14 , 18 , 19 , 36 , 38 , 40 , 42 , 43 , 46 , 50 , 51 , 53 , 55 , 57 , 63 , 67 , 68 , 70 , 76 , 78 , 83 , 84 , 86 , 87 , 88 , 91 , 93 , 100 , 102 , 109 ] of patients with minor or major depression episodes after PCMH-based care reported significant improvement in depression scores compared to patients with standard primary care. With the exceptions of three studies [ 46 , 91 , 102 ], twenty-two studies reporting changes in mean differences (continuous data) of depression scores showed significant reduction with a pooled SMD of −0.24 (95% CI −0.35, −0.14; p -value < 0.001) ( Figure 3 ).…”

Section: Resultsmentioning

confidence: 99%

“… 36 months ✓ ✓ Aragonès et al, 2014 (Cost-effectiveness) [ 37 ] Spain Treatment = 189 Control = 149 Overall = 47 years Overall = 80% Moderate or severe major depressive episode or minor depression Total direct costs—776.30 (664.10) Total indirect costs—718.30 (1587.70) Total direct costs—593.80 (603.10) Total indirect costs—743.40 (1582.10) Team based care; Co-ordinated care; Patient engagement; Continuity of care. 36 months ✓ Aragonès et al, 2019 [ 38 ] Spain Treatment = 167 Control = 161 Treatment = 61.4 years Control = 59.3 years Treatment = 82.6% Control = 83.2% Major depressive episode and experiencing moderate or severe musculoskeletal pain. HSCL-20 score; mean (SD) = 1.67 (0.80) BPI score; mean (SD) = 6.45 (1.87) HSCL-20 score; mean (SD) = 1.69 (0.68) BPI score; mean (SD) = 6.60 (1.77) MDT care, Patient engagement Coordinated care, Continuity of care 12 months ✓ Barcelo et al, 2010 [ 39 ] M...…”

Section: Table A1mentioning

confidence: 99%

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The Effectiveness of Patient-Centred Medical Home-Based Models of Care versus Standard Primary Care in Chronic Disease Management: A Systematic Review and Meta-Analysis of Randomised and Non-Randomised Controlled Trials

John

Jani

Peters

et al. 2020

IJERPH

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Patient-centred care by a coordinated primary care team may be more effective than standard care in chronic disease management. We synthesised evidence to determine whether patient-centred medical home (PCMH)-based care models are more effective than standard general practitioner (GP) care in improving biomedical, hospital, and economic outcomes. MEDLINE, CINAHL, Embase, Cochrane Library, and Scopus were searched to identify randomised (RCTs) and non-randomised controlled trials that evaluated two or more principles of PCMH among primary care patients with chronic diseases. Study selection, data extraction, quality assessment using Joanna Briggs Institute (JBI) appraisal tools, and grading of evidence using Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach were conducted independently. A quantitative synthesis, where possible, was pooled using random effects models and the effect size estimates of standardised mean differences (SMDs) and odds ratios (ORs) with 95% confidence intervals were reported. Of the 13,820 citations, we identified 78 eligible RCTs and 7 quasi trials which included 60,617 patients. The findings suggested that PCMH-based care was associated with significant improvements in depression episodes (SMD −0.24; 95% CI −0.35, −0.14; I2 = 76%) and increased odds of remission (OR 1.79; 95% CI 1.46, 2.21; I2 = 0%). There were significant improvements in the health-related quality of life (SMD 0.10; 95% CI 0.04, 0.15; I2 = 51%), self-management outcomes (SMD 0.24; 95% CI 0.03, 0.44; I2 = 83%), and hospital admissions (OR 0.83; 95% CI 0.70, 0.98; I2 = 0%). In terms of biomedical outcomes, with exception to total cholesterol, PCMH-based care led to significant improvements in blood pressure, glycated haemoglobin, and low-density lipoprotein cholesterol outcomes. The incremental cost of PCMH care was identified to be small and significantly higher than standard care (SMD 0.17; 95% CI 0.08, 0.26; I2 = 82%). The quality of individual studies ranged from “fair” to “good” by meeting at least 60% of items on the quality appraisal checklist. Additionally, moderate to high heterogeneity across studies in outcomes resulted in downgrading the included studies as moderate or low grade of evidence. PCMH-based care has been found to be superior to standard GP care in chronic disease management. Results of the review have important implications that may inform patient, practice, and policy-level changes.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Table A1mentioning

confidence: 99%

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The Effectiveness of Patient-Centred Medical Home-Based Models of Care versus Standard Primary Care in Chronic Disease Management: A Systematic Review and Meta-Analysis of Randomised and Non-Randomised Controlled Trials

John

Jani

Peters

et al. 2020

IJERPH

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“… 6 However, there were many studies that assessed outcomes over a period, 5 , 9 , 30 , 34 , 97 , 102 , 106 at flexible time points, 50 , 81 , 108 studies that defined several time points as primary, 75 , 111 and several that did not specify a primary point of follow-up. 3 , 8 , 26 , 59 , 66 , 83 , 109 , 122 A better indicator for how long self-declared pragmatic trials are, may thus be the longest time point of follow-up, for which the median was about one year after randomization (median 50 weeks, Q1/3; 23.25; 52 weeks; n = 56; not reported in one case 50 ). The shortest trial assessed peak chest pain during a stenting procedure for acute myocardial infarction, ie, lasted for no longer than a few hours after the intervention.…”

Section: Resultsmentioning

confidence: 99%

Pragmatic trials of pain therapies: a systematic review of methods

Hohenschurz-Schmidt

Kleykamp

Draper-Rodi³

et al. 2021

Pain

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“…Table 1 presents the baseline characteristics of patients included in the IPD by intervention arm. Thirteen studies (46.5%) in the IPD were conducted in the United States, [43][44][45][46][47][48][49][50][51][52][53][54][55] thirteen (46.5%) in Europe, [56][57][58][59][60][61][62][63][64][65][66][67][68] one (3.5%) in Canada, [69] and one (3.5%) in India. [70] We provide a summary table of IPD main effect and all moderator and sensitivity analyses in Table 2.…”

Section: Resultsmentioning

confidence: 99%

Effectiveness of Collaborative Care in Reducing Suicidal Ideation: An Individual Participant Data Meta-Analysis

Grigoroglou,

van der Feltz-Cornelis,

Hodkinson

et al. 2020

SSRN Journal

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To assess whether CC is more effective at reducing suicidal ideation in people with depression compared with usual care, and whether study and patient factors moderate treatment effects. Method: We searched Medline, Embase, PubMed, PsycINFO, CINAHL, CENTRAL from inception to March 2020 for Randomised Controlled Trials (RCTs) that compared the effectiveness of CC with usual care in depressed adults, and reported changes in suicidal ideation at 4 to 6 months post-randomisation. Mixed-effects models accounted for clustering of participants within trials and heterogeneity across trials. This study is registered with PROSPERO, CRD42020201747. Results: We extracted data from 28 RCTs (11,165 patients) of 83 eligible studies. We observed a small significant clinical improvement of CC on suicidal ideation, compared with usual care (SMD, −0.11 [95%CI, −0.15 to −0.08]; I 2 , 0⋅47% [95%CI 0.04% to 4.90%]). CC interventions with a recognised psychological treatment were associated with small reductions in suicidal ideation (SMD, −0.15 [95%CI -0.19 to −0.11]). CC was more effective for reducing suicidal ideation among patients aged over 65 years (SMD, − 0.18 [95%CI -0.25 to −0.11]). Conclusion: Primary care based CC with an embedded psychological intervention is the most effective CC framework for reducing suicidal ideation and older patients may benefit the most.

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Effectiveness of a collaborative care intervention for managing major depression and chronic musculoskeletal pain in primary care: A cluster-randomised controlled trial

Cited by 33 publications

References 38 publications

The Effectiveness of Patient-Centred Medical Home-Based Models of Care versus Standard Primary Care in Chronic Disease Management: A Systematic Review and Meta-Analysis of Randomised and Non-Randomised Controlled Trials

The Effectiveness of Patient-Centred Medical Home-Based Models of Care versus Standard Primary Care in Chronic Disease Management: A Systematic Review and Meta-Analysis of Randomised and Non-Randomised Controlled Trials

Pragmatic trials of pain therapies: a systematic review of methods

Effectiveness of Collaborative Care in Reducing Suicidal Ideation: An Individual Participant Data Meta-Analysis

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