Frost, R;
Beattie, A;
Bhanu, C;
Walters, K;
Ben-Shlomo, Y;
(2019)
Management of depression and referral of older people to psychological therapies: a systematic review of qualitative studies.
British Journal of General Practice
, 69
(680)
e171-e181.
10.3399/bjgp19X701297.
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Abstract
BACKGROUND: Depressive symptoms are common in later life and increase both the risk of functional and cognitive decline and the use of healthcare services. Despite older people expressing preferences for talking therapies, they are less likely to be referred than younger adults, particularly when aged ≥80 years. AIM: To explore how healthcare professionals (HCPs) manage older people in relation to depression and referrals to psychological therapies. DESIGN AND SETTING: Systematic review and thematic synthesis of qualitative studies. METHOD: MEDLINE, Embase, PsycINFO, CINAHL, and the Social Sciences Citation Index (inception-March 2018) were searched for studies exploring HCPs' views regarding management of late-life depression across all settings. Studies of older people's views or depression management across all ages were excluded. RESULTS: In total, 27 studies, were included; these predominantly focused on the views of GPs and primary and community care nurses. Many HCPs felt that late-life depression was mainly attributable to social isolation and functional decline, but treatments appropriate for this were limited. Clinicians perceived depression to have associated stigma for older adults, which required time to negotiate. Limited time in consultations and the complexity of needs in later life meant physical health was often prioritised over mental health, particularly in people with frailty. Good management of late-life depression appeared to depend more on the skills and interest of individual GPs and nurses than on any structured approach. CONCLUSION: Mental ill health needs to be a more-prominent concern in the care of older adults, with greater provision of psychological services tailored to later life. This may facilitate future identification and management of depression.
| Type: | Article |
|---|---|
| Title: | Management of depression and referral of older people to psychological therapies: a systematic review of qualitative studies |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.3399/bjgp19X701297 |
| Publisher version: | http://doi.org/10.3399/bjgp19X701297 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | aged, depression, frail elderly, primary health care, qualitative research, review |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Primary Care and Population Health |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10069695 |
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