Effectiveness of collaborative care in reducing suicidal ideation : an individual participant data meta-analysis

Grigoroglou, C; van der Feltz-Cornelis, C; Hodkinson, A; Coventry, PA; Zghebi, SS; Kontopantelis, E; Bower, P; Lovell, K; Gilbody, S; Waheed, W; Dickens, C; Archer, JE; Blakemore, A; Adler, DA; Aragones, E; Björkelund, C; Bruce, ML; Buszewicz, M; Carney, RM; Cole, MG; Davidson, KW; Gensichen, J; Grote, NK; Russo, J; Huijbregts, K; Huffman, JC; Menchetti, M; Patel, V; Richards, DA; Rollman, B; Smit, A; Zijlstra-Vlasveld, MC; Wells, KB; Zimmermann, T; Unutzer, J; Panagioti, M

Abstract

To assess whether CC is more effective at reducing suicidal ideation in people with depression compared with usual care, and whether study and patient factors moderate treatment effects. We searched Medline, Embase, PubMed, PsycINFO, CINAHL, CENTRAL from inception to March 2020 for Randomised Controlled Trials (RCTs) that compared the effectiveness of CC with usual care in depressed adults, and reported changes in suicidal ideation at 4 to 6 months post-randomisation. Mixed-effects models accounted for clustering of participants within trials and heterogeneity across trials. This study is registered with PROSPERO, CRD42020201747. We extracted data from 28 RCTs (11,165 patients) of 83 eligible studies. We observed a small significant clinical improvement of CC on suicidal ideation, compared with usual care (SMD, -0.11 [95%CI, -0.15 to -0.08]; I , 0·47% [95%CI 0.04% to 4.90%]). CC interventions with a recognised psychological treatment were associated with small reductions in suicidal ideation (SMD, -0.15 [95%CI -0.19 to -0.11]). CC was more effective for reducing suicidal ideation among patients aged over 65 years (SMD, - 0.18 [95%CI -0.25 to -0.11]). Primary care based CC with an embedded psychological intervention is the most effective CC framework for reducing suicidal ideation and older patients may benefit the most. [Abstract copyright: Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.]

Citation

Grigoroglou, C., van der Feltz-Cornelis, C., Hodkinson, A., Coventry, P., Zghebi, S., Kontopantelis, E., …Panagioti, M. (2021). Effectiveness of collaborative care in reducing suicidal ideation : an individual participant data meta-analysis. General Hospital Psychiatry, 71, 27-35. https://doi.org/10.1016/j.genhosppsych.2021.04.004

• Journal Article Type: Article
• Acceptance Date: Apr 18, 2021
• Online Publication Date: Apr 21, 2021
• Publication Date: Jul 1, 2021
• Deposit Date: May 13, 2021
• Publicly Available Date: May 13, 2021
• Journal: General hospital psychiatry
• Print ISSN: 0163-8343
• Electronic ISSN: 1873-7714
• Publisher: Elsevier
• Volume: 71
• Pages: 27-35
• DOI: https://doi.org/10.1016/j.genhosppsych.2021.04.004
• Publisher URL: https://doi.org/10.1016/j.genhosppsych.2021.04.004
• Related Public URLs: http://www.journals.elsevier.com/general-hospital-psychiatry/
• Additional Information: Additional Information : ** From PubMed via Jisc Publications Router **Journal IDs: eissn 1873-7714 **Article IDs: pubmed: 33915444; pii: S0163-8343(21)00054-2 **History: accepted 18-04-2021; revised 15-04-2021; submitted 02-03-2021