Skip to main content
PMC home page
Quality in Health Care : QHC logoLink to Quality in Health Care : QHC
. 1996 Dec;5(4):215–217. doi: 10.1136/qshc.5.4.215

What proportion of primary psychiatric interventions are based on evidence from randomised controlled trials?

J R Geddes 1, D Game 1, N E Jenkins 1, L A Peterson 1, G R Pottinger 1, D L Sackett 1
PMCID: PMC1055418  PMID: 10164145

Abstract

OBJECTIVES: To estimate the proportion of psychiatric inpatients receiving primary interventions based on randomised controlled trials or systematic reviews of randomised controlled trials. DESIGN: Retrospective survey. SETTING: Acute adult general psychiatric ward. SUBJECTS: All patients admitted to the ward during a 28 day period. MAIN OUTCOME MEASURES: Primary interventions were classified according to whether or not they were supported by evidence from randomised controlled trials or systematic reviews. RESULTS: The primary interventions received by 26/40 (65%; 95% confidence interval (95% CI) 51% to 79%) of patients admitted during the period were based on randomised trials or systematic reviews. CONCLUSIONS: When patients were used as the denominator, most primary interventions given in acute general psychiatry were based on experimental evidence. The evidence was difficult to locate; there is an urgent need for systematic reviews of randomised controlled trials in this area.

Full text

PDF
215

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Austin M. P., Souza F. G., Goodwin G. M. Lithium augmentation in antidepressant-resistant patients. A quantitative analysis. Br J Psychiatry. 1991 Oct;159:510–514. doi: 10.1192/bjp.159.4.510. [DOI] [PubMed] [Google Scholar]
  2. BURT C. G., GORDON W. F., HOLT N. F., HORDERN A. Amitriptyline in depressive states:a controlled trial. J Ment Sci. 1962 Sep;108:711–730. doi: 10.1192/bjp.108.456.711. [DOI] [PubMed] [Google Scholar]
  3. Baastrup P. C., Alhfors U. G., Bjerkenstedt L., Dencker S. J., Fensbo C., Gravem A., Pedersen V., Elgen K., Brekke B., Fredslund-Andersen K. A controlled Nordic multicentre study of zuclopenthixol acetate in oil solution, haloperidol and zuclopenthixol in the treatment of acute psychosis. Acta Psychiatr Scand. 1993 Jan;87(1):48–58. doi: 10.1111/j.1600-0447.1993.tb03329.x. [DOI] [PubMed] [Google Scholar]
  4. Caley C. F., Weber S. S. Sulpiride: an antipsychotic with selective dopaminergic antagonist properties. Ann Pharmacother. 1995 Feb;29(2):152–160. doi: 10.1177/106002809502900210. [DOI] [PubMed] [Google Scholar]
  5. Ellis J., Mulligan I., Rowe J., Sackett D. L. Inpatient general medicine is evidence based. A-Team, Nuffield Department of Clinical Medicine. Lancet. 1995 Aug 12;346(8972):407–410. [PubMed] [Google Scholar]
  6. Gill P., Dowell A. C., Neal R. D., Smith N., Heywood P., Wilson A. E. Evidence based general practice: a retrospective study of interventions in one training practice. BMJ. 1996 Mar 30;312(7034):819–821. doi: 10.1136/bmj.312.7034.819. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Guelfi J. D., Payan C., Fermanian J., Pedarriosse A. M., Manfredi R. Moclobemide versus clomipramine in endogenous depression. A double-blind randomised clinical trial. Br J Psychiatry. 1992 Apr;160:519–524. doi: 10.1192/bjp.160.4.519. [DOI] [PubMed] [Google Scholar]
  8. Johnson A. L. Clinical trials in psychiatry. Psychol Med. 1983 Feb;13(1):1–8. doi: 10.1017/s0033291700049990. [DOI] [PubMed] [Google Scholar]
  9. Jolley A. G., Hirsch S. R., Morrison E., McRink A., Wilson L. Trial of brief intermittent neuroleptic prophylaxis for selected schizophrenic outpatients: clinical and social outcome at two years. BMJ. 1990 Oct 13;301(6756):837–842. doi: 10.1136/bmj.301.6756.837. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. KURLAND A. A., HANLON T. E., TATOM M. H., OTA K. Y., SIMOPOULOS A. M. The comparative effectiveness of six phenothiazine compounds, phenobarbital and inert placebo in the treatment of acutely ill patients: global measures of severity of illness. J Nerv Ment Dis. 1961 Jul;133:1–18. doi: 10.1097/00005053-196107000-00001. [DOI] [PubMed] [Google Scholar]
  11. Kaim S. C., Klett C. J., Rothfeld B. Treatment of the acute alcohol withdrawal state: a comparison of four drugs. Am J Psychiatry. 1969 Jun;125(12):1640–1646. doi: 10.1176/ajp.125.12.1640. [DOI] [PubMed] [Google Scholar]
  12. Mant J., Hicks N. Detecting differences in quality of care: the sensitivity of measures of process and outcome in treating acute myocardial infarction. BMJ. 1995 Sep 23;311(7008):793–796. doi: 10.1136/bmj.311.7008.793. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Marder S. R., Meibach R. C. Risperidone in the treatment of schizophrenia. Am J Psychiatry. 1994 Jun;151(6):825–835. doi: 10.1176/ajp.151.6.825. [DOI] [PubMed] [Google Scholar]
  14. Oxman A. D., Cook D. J., Guyatt G. H. Users' guides to the medical literature. VI. How to use an overview. Evidence-Based Medicine Working Group. JAMA. 1994 Nov 2;272(17):1367–1371. doi: 10.1001/jama.272.17.1367. [DOI] [PubMed] [Google Scholar]
  15. Prien R. F., Caffey E. M., Jr, Klett C. J. Prophylactic efficacy of lithium carbonate in manic-depressive illness. Report of the Veterans Administration and National Institute of Mental Health collaborative study group. Arch Gen Psychiatry. 1973 Mar;28(3):337–341. doi: 10.1001/archpsyc.1973.01750330035006. [DOI] [PubMed] [Google Scholar]
  16. Stuppaeck C. H., Geretsegger C., Whitworth A. B., Schubert H., Platz T., König P., Hinterhuber H., Fleischhacker W. W. A multicenter double-blind trial of paroxetine versus amitriptyline in depressed inpatients. J Clin Psychopharmacol. 1994 Aug;14(4):241–246. [PubMed] [Google Scholar]

Articles from Quality in Health Care are provided here courtesy of BMJ Publishing Group

RESOURCES