Cited by 221Mental Health Treatment and AccessPsychotherapy Techniques and ApplicationsAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

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Characteristics of Effective Collaborative Care for Treatment of Depression: A Systematic Review and Meta-Regression of 74 Randomised Controlled Trials

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Coventry, Peter A., Hudson, Joanna L., Kontopantelis, Evangelos, Archer, Janine, Richards, David A., Gilbody, Simon, Lovell, Karina, Dickens, Chris, Gask, Linda, Waheed, Waquas, Bower, Peter·2014·PLoS ONE

DOI 10.1371/journal.pone.0108114PMC PMC4180075

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Abstract

BACKGROUND: Collaborative care is a complex intervention based on chronic disease management models and is effective in the management of depression. However, there is still uncertainty about which components of collaborative care are effective. We used meta-regression to identify factors in collaborative care associated with improvement in patient outcomes (depressive symptoms) and the process of care (use of anti-depressant medication). METHODS AND FINDINGS: Systematic review with meta-regression. The Cochrane Collaboration Depression, Anxiety and Neurosis Group trials registers were searched from inception to 9th February 2012. An update was run in the CENTRAL trials database on 29th December 2013. Inclusion criteria were: randomised controlled trials of collaborative care for adults ≥18 years with a primary diagnosis of depression or mixed anxiety and depressive disorder. Random effects meta-regression was used to estimate regression coefficients with 95% confidence intervals (CIs) between study level covariates and depressive symptoms and relative risk (95% CI) and anti-depressant use. The association between anti-depressant use and improvement in depression was also explored. Seventy four trials were identified (85 comparisons, across 21,345 participants). Collaborative care that included psychological interventions predicted improvement in depression (β coefficient -0.11, 95% CI -0.20 to -0.01, p = 0.03). Systematic identification of patients (relative risk 1.43, 95% CI 1.12 to 1.81, p = 0.004) and the presence of a chronic physical condition (relative risk 1.32, 95% CI 1.05 to 1.65, p = 0.02) predicted use of anti-depressant medication. CONCLUSION: Trials of collaborative care that included psychological treatment, with or without anti-depressant medication, appeared to improve depression more than those without psychological treatment. Trials that used systematic methods to identify patients with depression and also trials that included patients with a chronic physical condition reported improved use of anti-depressant medication. However, these findings are limited by the observational nature of meta-regression, incomplete data reporting, and the use of study aggregates.

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Authors: Coventry, P. A., Hudson, J. L., Kontopantelis, E., Archer, J., Richards, D. A., Gilbody, S., Lovell, K., Dickens, C., Gask, L., Waheed, W., & Bower, P.
Affiliations: Manchester Academic Health Science Centre (GB)
King's College London (GB)
University of Manchester (GB)
University of Exeter (GB)
University of York (GB)
Lancashire Care NHS Foundation Trust (GB)
Corresponding author: Coventry, Peter A.
ORCID: Coventry, Peter A.
Hudson, Joanna L.
Kontopantelis, Evangelos
Archer, Janine
Richards, David A.
Gilbody, Simon
Lovell, Karina
Dickens, Chris
Gask, Linda
Waheed, Waquas
Bower, Peter
Venue: PLoS ONE
Publisher: Public Library of Science (PLoS)
Published: 2014-09-29
Volume: 9
Issue: 9
Pages: e108114
ISSN: 1932-6203 (ISSN-L)
DOI: 10.1371/journal.pone.0108114
PMC: PMC4180075
OpenAlex: W2096684104
Cited by: 221
References: 56
Citations by year: 2026: 12 · 2025: 7 · 2024: 22 · 2023: 15 · 2022: 20 · 2021: 30 · 2020: 25 · 2019: 17 · 2018: 18 · 2017: 23 · 2016: 23 · 2015: 9
FWCI: 2.62
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by
creativecommons.org/licenses/by/4.0/ (unspecified)
Locations: PLoS ONE (publishedVersion, cc-by)
Europe PMC (PubMed Central) (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
Open Research Exeter (University of Exeter) (publishedVersion, other-oa)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Figshare (submittedVersion, cc-by)
Figshare (submittedVersion)
Research Portal (King's College London) (submittedVersion, cc-by)
Research Explorer (The University of Manchester) (submittedVersion, cc-by)
Funders: National Institute for Health and Care Research (NF-SI-0611-10203, 08/19/04, 10/57/43, RCF_R10_PC)
Medical Research Council (MR/K006665/1, MC_PC_13042)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords: collaborative care, depression, mixed anxiety-depressive disorder, psychological intervention, antidepressant use, chronic physical illness, patient identification, depressive symptoms, complex interventions
MeSH terms: Antidepressive Agents, Cooperative Behavior, Depression, Humans, Randomized Controlled Trials as Topic

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Characteristics of Effective Collaborative Care for Treatment of Depression: A Systematic Review and Meta-Regression of 74 Randomised Controlled Trials

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