Collaborative care for depression in European countries: A systematic review and meta-analysis

AbstractObjectives s a systematic review and meta-analysis of randomized controlled trials (RCTs) investigating the effectiveness of collaborative care compared to Primary Care Physicianʹs (PCPʹs) usual care in the treatment of depression, focusing on European countries. s ematic review of English and non-English articles, from inception to March 2014, was performed using database PubMed, British Nursing Index and Archive, Ovid Medline (R), PsychINFO, Books@Ovid, PsycARTICLES Full Text, EMBASE Classic + Embase, DARE (Database of Abstract of Reviews of Effectiveness) and the Cochrane Library electronic database. Search term included depression, collaborative care, physician family and allied health professional. RCTs comparing collaborative care to usual care for depression in primary care were included. Titles and abstracts were independently examined by two reviewers, who extracted from the included trials information on participantsʹ characteristics, type of intervention, features of collaborative care and type of outcome measure. s papers included, regarding 15 RCTs, involved 3240 participants. Primary analyses showed that collaborative care models were associated with greater improvement in depression outcomes in the short term, within 3 months (standardized mean difference (SMD) − 0.19, 95% CI = − 0.33; − 0.05; p = 0.006), medium term, between 4 and 11 months (SMD − 0.24, 95% CI = − 0.39; − 0.09; p = 0.001) and medium–long term, from 12 months and over (SMD − 0.21, 95% CI = − 0.37; − 0.04; p = 0.01), compared to usual care. sions esent review, specifically focusing on European countries, shows that collaborative care is more effective than treatment as usual in improving depression outcomes.