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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; ... Panagioti, M; + view all (2021) Effectiveness of collaborative care in reducing suicidal ideation: An individual participant data meta-analysis. General Hospital Psychiatry , 71 pp. 27-35. 10.1016/j.genhosppsych.2021.04.004. Green open access

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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. METHOD: 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. RESULTS: 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]; I2, 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]). CONCLUSION: 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.

Type: Article
Title: Effectiveness of collaborative care in reducing suicidal ideation: An individual participant data meta-analysis
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.genhosppsych.2021.04.004
Publisher version: http://dx.doi.org/10.1016/j.genhosppsych.2021.04.0...
Language: English
Additional information: © 2021 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
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/10130619
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