The role of relapse prevention for depression in collaborative care : a systematic review

Moriarty, AS; Coventry, PA; Hudson, JL; Cook, N; Fenton, OJ; Bower, P; Lovell, K; Archer, JE; Clarke, R; Richards, DA; Dickens, C; Gask, L; Waheed, W; Huijbregts, KM; van der Feltz-Cornelis, C; Ali, S; Gilbody, S; McMillan, D

Abstract

Relapse (the re-emergence of depression symptoms before full recovery) is common in depression and relapse prevention strategies are not well researched in primary care settings. Collaborative care is effective for treating acute phase depression but little is known about the use of relapse prevention strategies in collaborative care. We undertook a systematic review to identify and characterise relapse prevention strategies in the context of collaborative care. We searched for Randomised Controlled Trials (RCTs) of collaborative care for depression. In addition to published material, we obtained provider and patient manuals from authors to provide more detail on intervention content. We reported the extent to which collaborative care interventions addressed four relapse prevention components. 93 RCTs were identified. 31 included a formal relapse prevention plan; 42 had proactive monitoring and follow-up after the acute phase; 39 reported strategies for optimising sustained medication adherence; and 20 of the trials reported psychological or psycho-educational treatments persisting beyond the acute phase or focussing on long-term health/relapse prevention. 30 (32.3%) did not report relapse prevention approaches. We did not receive trial materials for approximately half of the trials, which limited our ability to identify relevant features of intervention content. Relapse is a significant risk amongst people treated for depression and interventions are needed that specifically address and minimise this risk. Given the advantages of collaborative care as a delivery system for depression care, there is scope for more consistency and increased effort to implement and evaluate relapse prevention strategies. [Abstract copyright: Copyright © 2019. Published by Elsevier B.V.]

Citation

Moriarty, A., Coventry, P., Hudson, J., Cook, N., Fenton, O., Bower, P., …McMillan, D. (2020). The role of relapse prevention for depression in collaborative care : a systematic review. Journal of Affective Disorders, 265, 618-644. https://doi.org/10.1016/j.jad.2019.11.105

• Journal Article Type: Article
• Acceptance Date: Nov 21, 2019
• Online Publication Date: Nov 22, 2019
• Publication Date: Mar 15, 2020
• Deposit Date: Feb 19, 2020
• Publicly Available Date: Nov 21, 2020
• Journal: Journal of Affective Disorders
• Print ISSN: 0165-0327
• Publisher: Elsevier
• Volume: 265
• Pages: 618-644
• DOI: https://doi.org/10.1016/j.jad.2019.11.105
• Publisher URL: https://doi.org/10.1016/j.jad.2019.11.105
• Related Public URLs: https://sciencedirect.com/journal/journal-of-affective-disorders
• Additional Information: Additional Information : ** From PubMed via Jisc Publications Router **Journal IDs: eissn 1573-2517 **Article IDs: pubmed: 31791677; pii: S0165-0327(19)30734-7 **History: accepted 21-11-2019; revised 01-10-2019; submitted 19-04-2019