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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...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Nature Publishing Group UK
2021
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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 |
format | Online Article Text |
id | pubmed-8520525 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
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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