Collaborative care for depression in primary care: Making sense of a complex intervention: systematic review and meta-regression
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Background: The management of depression in primary care is a significant issue for health services worldwide. ‘Collaborative care’ interventions are effective, but little is known about which aspects of these complex interventions are essential. Aims: To use meta-regression to identify ‘active ingredients' in collaborative care models for depression in primary care. Method: Studies were identified using systematic searches of electronic databases. The content of collaborative care interventions was coded, together with outcome data on antidepressant use and depressive symptoms. Meta-regression was used to examine relationships between intervention content and outcomes. Results: There was no significant predictor of the effect of collaborative care on antidepressant use. Key predictors of depressive symptom outcomes included systematic identification of patients, professional background of staff and specialist supervision. Conclusions: Meta-regression may be useful in examining ‘active ingredients' in complex interventions in mental health.
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A sample size of 100 screen-positive participants in 24 clusters provided over 90% power to detect a difference in recovery rates of 70% in the intervention arm versus 50% in the control arm.
“The resulting sample size of 100 screen-positive participants in 24 clusters provides over 90% power to detect a difference in recovery rates of 70% in the CSC arm versus 50% in the EUC control arm, with estimates based on earlier efficacy trials in Goa [15] and Chile [17].”
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- Authors
- Bower, P., Gilbody, S., Richards, D., Fletcher, J., & Sutton, A.
- Affiliations
- University of Manchester (GB)
- University of York (GB)
- University of Leicester (GB)
- Corresponding author
- Bower, Peter
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2006-12
- Volume
- 189
- Issue
- 6
- Pages
- 484-493
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- OpenAlex
- W2114487236
- Cited by
- 429
- References
- 82
- Citations by year
- 2026: 4 · 2025: 7 · 2024: 17 · 2023: 6 · 2022: 12 · 2021: 22 · 2020: 23 · 2019: 15 · 2018: 12 · 2017: 28 · 2016: 18 · 2015: 33 · 2014: 51 · 2013: 29 · 2012: 34
- FWCI
- 2.67
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (publishedVersion)
- Funders
- Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
- Medical Research Council
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- collaborative care, depression, primary care, complex interventions, active ingredients, antidepressant use, depressive symptoms, mental health services
- MeSH terms
- Depressive Disorder, Humans, Interprofessional Relations, Mental Health Services, Patient Care Team, Primary Health Care, Treatment Outcome
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