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Collaborative care for depression in UK primary care: a randomized controlled trial

  • D. A. Richards (a1), K. Lovell (a2), S. Gilbody (a1), L. Gask (a3), D. Torgerson (a1), M. Barkham (a4), M. Bland (a1), P. Bower (a3), A. J. Lankshear (a5), A. Simpson (a1), J. Fletcher (a2), D. Escott (a2), S. Hennessy (a1) and R. Richardson (a1)
  • DOI: http://dx.doi.org/10.1017/S0033291707001365
  • Published online: 01 September 2007
Abstract
Background

Collaborative care is an effective intervention for depression which includes both organizational and patient-level intervention components. The effect in the UK is unknown, as is whether cluster- or patient-randomization would be the most appropriate design for a Phase III clinical trial.

Method

We undertook a Phase II patient-level randomized controlled trial in primary care, nested within a cluster-randomized trial. Depressed participants were randomized to ‘collaborative care’ – case manager-coordinated medication support and brief psychological treatment, enhanced specialist and GP communication – or a usual care control. The primary outcome was symptoms of depression (PHQ-9).

Results

We recruited 114 participants, 41 to the intervention group, 38 to the patient randomized control group and 35 to the cluster-randomized control group. For the intervention compared to the cluster control the PHQ-9 effect size was 0.63 (95% CI 0.18–1.07). There was evidence of substantial contamination between intervention and patient-randomized control participants with less difference between the intervention group and patient-randomized control group (−2.99, 95% CI −7.56 to 1.58, p=0.186) than between the intervention and cluster-randomized control group (−4.64, 95% CI −7.93 to −1.35, p=0.008). The intra-class correlation coefficient for our primary outcome was 0.06 (95% CI 0.00–0.32).

Conclusions

Collaborative care is a potentially powerful organizational intervention for improving depression treatment in UK primary care, the effect of which is probably partly mediated through the organizational aspects of the intervention. A large Phase III cluster-randomized trial is required to provide the most methodologically accurate test of these initial encouraging findings.

Copyright
Corresponding author
*Address for correspondence: Professor D. A. Richards, Department of Health Sciences, Seebohm Rowntree Building, University of York, University Road, Heslington, York, North Yorkshire, United Kingdom. (Email: dr17@york.ac.uk)
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This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

M Barkham , F Margison , C Leach , M Lucock , J Mellor-Clark , C Evans , L Benson , J Connell , K Audin , G McGrath (2001). Service profiling and outcomes benchmarking using the CORE-OM: towards practice-based evidence in the psychological therapies. Journal of Consulting and Clinical Psychology 69, 184196.

M Blanchard , A Waterreus , A Mann (1995). The effect of primary care nurse intervention upon older people screened as depressed. International Journal of Geriatric Psychiatry 10, 289298.

P Bower , S Gilbody (2005). Managing common mental health disorders in primary care: conceptual models and evidence base. British Medical Journal 330, 839842.

M Campbell , R Fitzpatrick , A Haines , AL Kinmonth , P Sandercock , D Spiegelhalter , P Tyrer (2000). Framework for design and evaluation of complex interventions to improve health. British Medical Journal 321, 694696.

J Cohen (1988). Statistical Power Analysis for the Behavioral Sciences. Erlbaum: Hillsdale, NJ.

P Cuijpers , A van Straten , L Warmerdam (2007). Behavioural activation treatments of depression: a meta analysis. Clinical Psychology Review 27, 318326.

S Dimidjian , S Hollon , K Dobson , KB Schmaling , RJ Kohlenberg , ME Addis , R Gallo , JB McGlinchey , DK Markley , JK Gollan , DC Atkins , DL Dunne , NS Jacobson (2006). Randomized trial of behavioural activation, cognitive therapy, and antidepressant medication in the acute treatment of adults with major depression. Journal of Consulting and Clinical Psychology 74, 658670.

S Gilbody , P Bower , J Fletcher , DA Richards , A Sutton (2006). Collaborative care for depression: a systematic review and cumulative meta-analysis. Archives of Internal Medicine 166, 23142321.

S Gilbody , P Whitty , J Grimshaw , R Thomas (2003). Educational and organizational interventions to improve the management of depression in primary care: a systematic review. Journal of the American Medical Association 289, 31453151.

J Gunn , J Diggens , K Hegarty , G Blashki (2006). A systematic review of complex system interventions designed to increase recovery from depression in primary care. BMC Health Services Research 6, 88.

N Jacobson , K Dobson , P Traux , ME Addis , K Koerner , JK Gollan , E Gortner , SE Prince (1996). A component analysis of cognitive-behavioural treatment of depression. Journal of Consulting and Clinical Psychology 64, 295304.

W Katon , M Von Korff , E Lin , G Simon , E Walker , J Unützer , T Bush , J Russo , E Ludman (1999). Stepped collaborative care for primary care patients with persistent symptoms of depression: a randomized trial. Archives of General Psychiatry 56, 11091115.

K Kroenke , RL Spitzer , JB Williams (2001). The PHQ-9: validity of a brief depression severity measure. Journal of General Internal Medicine 16, 606613.

R Layard (2006). The case for psychological treatment centres. British Medical Journal 332, 10301032.

R Peveler , C George , A Kinmonth , M Campbell , C Thompson (1999). Effect of antidepressant drug counselling and information leaflets on adherence to drug treatment in primary care: randomised controlled trial. British Medical Journal 319, 612615.

DA Richards , AJ Lankshear , J Fletcher , A Rogers , M Barkham , P Bower , L Gask , S Gilbody , K Lovell (2006 a). Developing a UK protocol for collaborative care: a qualitative study. General Hospital Psychiatry 28, 296305.

G Simon (2006). Collaborative care for depression. British Medical Journal 332, 249250.

RL Spitzer , JB Williams , M Gibbon , MB First (1992). The Structured Clinical Interview for DSM-III-R (SCID). I: History, rationale, and description. Archives of General Psychiatry 49, 624629.

OC Ukoumunne , MC Gulliford , S Chinn , JA Sterne , PG Burney , A Donner (1999). Methods in health service research. Evaluation of health interventions at area and organisation level. British Medical Journal 319, 376379.

J Unutzer , W Katon , CM Callahan , Jr. JW Williams , E Hunkeler , L Harpole , M Hoffing , Penna RD Della , PH Noel , EH Lin , PA Arean , MT Hegel , L Tang , TR Belin , S Oishi , C Langston , IMPACT Investigators (2002). Collaborative care management of late-life depression in the primary care setting: a randomized controlled trial. Journal of the American Medical Association 288, 28362845.

M Von Korff , D Goldberg (2001). Improving outcomes in depression. British Medical Journal 323, 948949.

EH Wagner , BT Austin & M Von Korff (1996). Organizing care for patients with chronic illness. Milbank Quarterly 74, 511544.

KB Wells , C Sherbourne , M Schoenbaum , N Duan , L Meredith , J Unutzer , J Miranda , MF Carney , LV Rubenstein (2000). Impact of disseminating quality improvement programs for depression in managed primary care: a randomized controlled trial. Journal of the American Medical Association 283, 212220.

H White (1980). A heteroskedasticity-consistent covariance matrix estimator and a direct test for heteroskedasticity. Econometrica 48, 817838.

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