Effects of a stepped-care intervention programme among older subjects who screened positive for depressive symptoms in general practice: the PROMODE randomised controlled trial

Weele, Gerda M van der; Waal, Margot W. M. de; Craen, Anton J. M. de; Spinhoven, Philip; Stijnen, Theo; Assendelft, W.J.J.; Mast, Roos C. van der; Gussekloo, Jacobijn

doi:10.1093/ageing/afs027

Cited by 34 publications

(45 citation statements)

References 26 publications

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“…The ideal test, against true matched care or against high-intensity care for all patients, has not been performed yet. We identified five (Dutch) protocol papers on stepped care (Braamse et al 2010;Krebber et al 2012;Pommer et al 2012;Van der Weele et al 2012;Van Dijk et al 2013); none compared stepped with matched care or with intensive psychological treatment for all.…”

Section: Discussionmentioning

confidence: 99%

Stepped care treatment delivery for depression: a systematic review and meta-analysis

et al. 2014

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Abstract:Background In stepped-care models patients typically start with a low intensity evidence-based treatment. Progress is monitored systematically and those patients who do not respond adequately step up to a subsequent treatment of higher intensity. Despite the fact that many guidelines have endorsed this stepped care principle it is not clear if stepped care really delivers similar or better patient outcomes against lower costs compared to other systems. We performed a systematic review and metaanalysis of all randomised trials on stepped care for depression.Methods We carried out a comprehensive literature search. Selection of studies, evaluation of study quality, and extraction of data, was performed independently by two authors.Results Fourteen studies were included and ten were used in the meta-analyses (4,580 patients). All studies used screening to identify possible patients and care-asusual as a comparator. Study quality was relatively high. Stepped care had a moderate effect on depression (pooled six month between group effect size Cohen's d was 0.34; 95% confidence interval 0.20 to 0.48). The stepped care interventions varied a lot in number and duration of treatment steps, treatments offered, professionals involved, and criteria to step up.Conclusions There is currently only limited evidence to suggest that stepped care should be the dominant model of treatment organisation. Evidence on (cost-) effectiveness compared with high intensity psychological therapy alone, as well as with matched care, is required. Powered by Editorial Manager® and ProduXion Manager® from Aries Systems CorporationStepped care treatment delivery for depression: AbstractBackground In stepped-care models patients typically start with a low intensity evidence-based

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Section: Discussionmentioning

confidence: 99%

Stepped care treatment delivery for depression: a systematic review and meta-analysis

et al. 2014

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“…The primary aim of the PROMODE trial was to investigate the (cost‐) effectiveness of a stepped‐care intervention program among older persons with depressive symptoms (van der Weele et al, ). A total of 2759 participants aged 75 years and above were recruited from primary care practices between April 2007 and July 2008.…”

Section: Methodsmentioning

confidence: 99%

“…No valid, easily applicable screening tool for apathy is available for use in general clinical practice (Clarke et al, 2011;Radakovic et al, 2015). Because of its association with adverse health outcomes, apathy is increasingly prioritized on research agendas, with subsequent expanding knowledge on its specific prognostic (Ligthart et al, 2012;Van der Mast et al, 2008) and possibly causal factors (Benoit and Robert, 2011;Grool et al, 2014;Stella et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

Validity of the three apathy items of the Geriatric Depression Scale (GDS‐3A) in measuring apathy in older persons

Bertens

Moonen

Waal

et al. 2016

Int J Geriat Psychiatry

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“…Nevertheless, it could be that this lack of awareness is because patients do not identify themselves as being at increased risk of depression. In a study among older patients (> 74 years) with depressive symptoms, only a small percentage of the depressive patients (19%) started a course, and the main reason for their not participating was not feeling depressed (van der Weele et al, 2012a, van der Weele et al, 2012b). …”

Section: Discussionmentioning

confidence: 99%

Favourable outcomes of a preventive screening and counselling programme for older people in underprivileged areas in the Netherlands: The PRIMUS project

Dijk¹,

Crone

Empelen

et al. 2017

Preventive Medicine Reports

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An aging population is associated with an increased prevalence of diabetes, cardiovascular diseases and depression. Important aspects of programmes targeted at older people are: to reach those at risk, effective screening, optimising advice, and referral to local interventions. We examined the effect of a preventive health consultation (PRIMUS), a multi-behavioural screening programme for persons aged 55–74 years in primary care. In a multi-centre randomised controlled trial, the effects of participating in the PRIMUS intervention were compared to a comparison group receiving personalised summaries and advice by postal mail, both preceded by a health risk assessment via a questionnaire. The intervention consisted of a baseline health risk assessment, followed by a preventive health consultation (after 4 weeks), and a follow-up visit (2 weeks later) in the primary care centre. A newly developed web-based computer-tailored programme supported the nurse practitioner during the consultation. Main outcomes measures were awareness of, and compliance with referral advice for changing unhealthy lifestyles. The PRIMUS preventive health consultation was successful in older people at risk for cardio metabolic diseases compared to the comparison group (compliance: RR 1.43; 95% CI 1.12–1.79; p < 0.05). The intervention was less successful in older people at risk for mental health problems. This preventive health consultation for older people resulted in positive changes in unhealthy behaviours by optimising reach, raising awareness, motivating and assisting individuals to change, and referring to local interventions.

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Effects of a stepped-care intervention programme among older subjects who screened positive for depressive symptoms in general practice: the PROMODE randomised controlled trial

Abstract: www.controlled-trials.com/ISRCTN 71142851v.

Cited by 34 publications

References 26 publications

Stepped care treatment delivery for depression: a systematic review and meta-analysis

Stepped care treatment delivery for depression: a systematic review and meta-analysis

Validity of the three apathy items of the Geriatric Depression Scale (GDS‐3A) in measuring apathy in older persons

Favourable outcomes of a preventive screening and counselling programme for older people in underprivileged areas in the Netherlands: The PRIMUS project

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