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The effectiveness of enhanced evidence-based care for depressive disorders: a meta-analysis of randomized controlled trials

Several care models have been developed to improve treatment for depression, all of which provide “enhanced” evidence-based care (EEC). The essential component of these approaches is Measurement-Based Care (MBC). Specifically, Collaborative Care (CC), and Algorithm-guided Treatment (AGT), and Integr...

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Autores principales: Xiao, Le, Qi, Han, Zheng, Wei, Xiang, Yu-Tao, Carmody, Thomas J., Mayes, Taryn L., Trivedi, Madhukar H., Wang, Gang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8520525/
https://www.ncbi.nlm.nih.gov/pubmed/34657142
http://dx.doi.org/10.1038/s41398-021-01638-7
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author Xiao, Le
Qi, Han
Zheng, Wei
Xiang, Yu-Tao
Carmody, Thomas J.
Mayes, Taryn L.
Trivedi, Madhukar H.
Wang, Gang
author_facet Xiao, Le
Qi, Han
Zheng, Wei
Xiang, Yu-Tao
Carmody, Thomas J.
Mayes, Taryn L.
Trivedi, Madhukar H.
Wang, Gang
author_sort Xiao, Le
collection PubMed
description Several care models have been developed to improve treatment for depression, all of which provide “enhanced” evidence-based care (EEC). The essential component of these approaches is Measurement-Based Care (MBC). Specifically, Collaborative Care (CC), and Algorithm-guided Treatment (AGT), and Integrated Care (IC) all use varying forms of rigorous MBC assessment, care management, and/or treatment algorithms as key instruments to optimize treatment delivery and outcomes for depression. This meta-analysis systematically examined the effectiveness of EEC versus usual care for depressive disorders based on cluster-randomized studies or randomized controlled trials (RCTs). PubMed, the Cochrane Library, and PsycInfo, EMBASE, up to January 6th, 2020 were searched for this meta-analysis. The electronic search was supplemented by a manual search. Standardized mean difference (SMD), risk ratio (RR), and their 95% confidence intervals (CIs) were calculated and analyzed. A total of 29 studies with 15,255 participants were analyzed. EEC showed better effectiveness with the pooled RR for response of 1.30 (95%CI: 1.13–1.50, I(2) = 81.9%, P < 0.001, 18 studies), remission of 1.35 (95%CI: 1.11–1.64, I(2) = 85.5%, P < 0.001, 18 studies) and symptom reduction with a pooled SMD of −0.42 (95%CI: −0.61–(−0.23), I(2) = 94.3%, P < 0.001, 19 studies). All-cause discontinuations were similar between EEC and usual care with the pooled RR of 1.08 (95%CI: 0.94–1.23, I(2) = 68.0%, P = 0.303, 27 studies). This meta-analysis supported EEC as an evidence-based framework to improve the treatment outcome of depressive disorders. Review registration: PROSPERO: CRD42020163668
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spelling pubmed-85205252021-10-29 The effectiveness of enhanced evidence-based care for depressive disorders: a meta-analysis of randomized controlled trials Xiao, Le Qi, Han Zheng, Wei Xiang, Yu-Tao Carmody, Thomas J. Mayes, Taryn L. Trivedi, Madhukar H. Wang, Gang Transl Psychiatry Review Article Several care models have been developed to improve treatment for depression, all of which provide “enhanced” evidence-based care (EEC). The essential component of these approaches is Measurement-Based Care (MBC). Specifically, Collaborative Care (CC), and Algorithm-guided Treatment (AGT), and Integrated Care (IC) all use varying forms of rigorous MBC assessment, care management, and/or treatment algorithms as key instruments to optimize treatment delivery and outcomes for depression. This meta-analysis systematically examined the effectiveness of EEC versus usual care for depressive disorders based on cluster-randomized studies or randomized controlled trials (RCTs). PubMed, the Cochrane Library, and PsycInfo, EMBASE, up to January 6th, 2020 were searched for this meta-analysis. The electronic search was supplemented by a manual search. Standardized mean difference (SMD), risk ratio (RR), and their 95% confidence intervals (CIs) were calculated and analyzed. A total of 29 studies with 15,255 participants were analyzed. EEC showed better effectiveness with the pooled RR for response of 1.30 (95%CI: 1.13–1.50, I(2) = 81.9%, P < 0.001, 18 studies), remission of 1.35 (95%CI: 1.11–1.64, I(2) = 85.5%, P < 0.001, 18 studies) and symptom reduction with a pooled SMD of −0.42 (95%CI: −0.61–(−0.23), I(2) = 94.3%, P < 0.001, 19 studies). All-cause discontinuations were similar between EEC and usual care with the pooled RR of 1.08 (95%CI: 0.94–1.23, I(2) = 68.0%, P = 0.303, 27 studies). This meta-analysis supported EEC as an evidence-based framework to improve the treatment outcome of depressive disorders. Review registration: PROSPERO: CRD42020163668 Nature Publishing Group UK 2021-10-16 /pmc/articles/PMC8520525/ /pubmed/34657142 http://dx.doi.org/10.1038/s41398-021-01638-7 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Review Article
Xiao, Le
Qi, Han
Zheng, Wei
Xiang, Yu-Tao
Carmody, Thomas J.
Mayes, Taryn L.
Trivedi, Madhukar H.
Wang, Gang
The effectiveness of enhanced evidence-based care for depressive disorders: a meta-analysis of randomized controlled trials
title The effectiveness of enhanced evidence-based care for depressive disorders: a meta-analysis of randomized controlled trials
title_full The effectiveness of enhanced evidence-based care for depressive disorders: a meta-analysis of randomized controlled trials
title_fullStr The effectiveness of enhanced evidence-based care for depressive disorders: a meta-analysis of randomized controlled trials
title_full_unstemmed The effectiveness of enhanced evidence-based care for depressive disorders: a meta-analysis of randomized controlled trials
title_short The effectiveness of enhanced evidence-based care for depressive disorders: a meta-analysis of randomized controlled trials
title_sort effectiveness of enhanced evidence-based care for depressive disorders: a meta-analysis of randomized controlled trials
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8520525/
https://www.ncbi.nlm.nih.gov/pubmed/34657142
http://dx.doi.org/10.1038/s41398-021-01638-7
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