Table 3

Study Results

Study

Follow Up

Attrition Rate %a

Outcome

Results

Limitations

Effect Sizeb


Baker (2001) [36]

16 weeks

6

Proportion of patients w/BDI < 11

Sign. diff in proportion of patients w/BDI > 11 (OR = 2.5)

Tailored intervention that makes GP comparison impossible since they all received diff kinds of intervention

/


Bosmans (2006) [33]

12 mo

21

PRIME-MD

No sign. diff in MD recovery

Possible Hawthorne effect, less severe episodes of MD in primary care, no blinding of patients

-0.07


Gask (2004) [38]

3, 12 mo

37

HAM-D

No sign. diff in scores at both follow up points

Use of a new-onset (depressed less than 6 mo) sample

Attrition rate rather high

-0.24


Kendrick (2001) [34]

12 mo

19

Hospital Admittance

No sign. difference

Implemented guidelines had been tested in highly selected samples

Dimensional diagnosis

Potential conservative bias (chronic depressed patients)

/


Thompson (2000) [35]

6 weeks/6 mo

50

HAD

No diff in improvement, no diff in caseness rating at both points

Only patients recognized as cases at baseline improve sign. during first 6 weeks (p = 0.044), no diff at 6 mo

See Kendrick (2001)

/


Diagnosis sensitivity

No diff in sensitivity nor specificity

See Kendrick (2001)

/


King (2002) [41]

6 mo

10

BDI

No sign. diff in BDI scores (p = 0.84)

Smaller sample than anticipated

Cut off score for inclusion rather high (makes intervention effect of CBT by lay GPs less likely)

0.08


Llewellyn-Jones (1999)

[40]

9.5 mo

23

GDS

Sign. change in GDS scores

Serial mono-centered design

Control group assessment before implementation of intervention

-0.17


Rost (2001) [44]

6 mo

10

mCES-D

Sign. reduction in score in patients beginning new treatment episode

GP training effect unclear, feedback of diagnosis could be responsible for treatment effect

Homogenous sample

-0.29


Pyne (2003) [43]

12 mo

65

Depression severity

Sign. decrease (7.7 units) in experimental group

See Rost (2001)

/


Rost (2005) [45]

24 mo

70

Depression Free Days

Sign. more depression free days in experimental group (647.6 vs. 558.2)

See Rost (2001)

/


Worrall (1999) [39]

6 mo

?

Gain score CES-D

Sign. improvement in experimental group

Possible Hawthorne effect

-0.22


a all groups, last follow up;b calculated as the mean difference of experimental and control group at the latest post-treatment measurement;c adopted from Bower et al. (2006) [45].

Abbreviations: BDI - Beck's Depression Inventory; CBT - Cognitive Behavioral Therapy; CE Ratio - Cost Effectiveness Ratio; mCES-D - (modified) Center for Epidemiologic Studies Depression Scale; CIDI - Composite International Diagnostic Interview; diff - difference; GDS - Geriatric Depression Scale; GP - General Practitioner; HAD - Hospital Anxiety and Depression Scale; HAM-D Hamilton Depression Scale; mo - month(s); MD - Major Depression; PRIME-MD - Primary care Evaluation of Mental Disorders; QALY - Quality of Adjusted Life Year; SF12 - Short Form 12-Item Health Survey; sign - significant

Sikorski et al. BMC Health Services Research 2012 12:10   doi:10.1186/1472-6963-12-10

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