Evaluation of Counselling in a General Practice Setting: Preliminary Communication

Abstract

IntroducionThe cost of prescriptions for minor tranquillizers, antidepressants and hypnotic drugs has risen dramatically over the past decade. This preliminary report describes a study in progress where counselling facilities are made available in the general practice setting to a random sample of patients consulting their doctor for minor psychological disturbance. The acceptability of counselling and its effect on psychotropic drug prescribing and GP consultation rate will be used as indicators of the effectiveness of the counselling provided. A more flexible approach to counselling, suited to the work-load and time constraints of the primary care setting, is being explored.

Systematic review of the effect of on-site mental health professionals on the clinical behaviour of general practitioners

“…We identified 40 relevant outcomes: 13 randomised controlled trials of direct effects on consultation rates (table A on website)10 – 23; 12 randomised controlled trials of direct effects on prescribing (table B on website) 10 – 14 18 – 25; six randomised controlled trials of direct effects on referrals (table C on website) 11 15 18 22 – 25; three controlled before and after studies of indirect effects on prescribing (table D on website)26 – 29; and six controlled before and after studies of indirect effects on referrals (table E on website). 26 27 29 – 32…”

“…16 18 20 Of the 12 studies of prescribing behaviour, five found significant reductions in the mental health professional group. 10 11 19 – 21 The effects were not always consistent within studies in terms of the different drugs examined and the duration of the effect. Three of the six randomised controlled trials of referral behaviour reported significant reductions in the mental health professional group.…”

“…Follow up rates of greater than 80% were reported in five studies, 10 – 12 16 19 less than 80% in two, 13 17 and eight did not provide information. Sample sizes ranged from 44 to 429 (mean 152).…”

“…Concealment of allocation was considered adequate in two studies, 15 23 open to bias in three, 10 16 24 and unclear from information provided by the remainder. Follow up rates of greater than 80% were reported in five studies, 10 – 12 16 19 less than 80% in two, 13 17 and eight did not provide information.…”

Analysis of the apiclutural industry in relation to geothermal development and agriculture in the Imperial Valley, Imperial County, California

“…Table 6 presents a recapitulation of the 11-year average acerage o f agricultural crops grown and quantity of animal and animal products in Imperial County divided into bee foraged versus non-bee foraged crops. These basic data were adapted from the Imperial County Agricultural Commissioner Annual Reports (6)(7)(8)(9)(10)(11)(12)(13)(14). This recapitulation demostrates that 27.2% of the total acerage grown in the county comprises bee foraged crops and 72.8% comprises non-bee foraged crops.…”