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. 2024 May 7;2024(5):CD009531. doi: 10.1002/14651858.CD009531.pub3

Comparison 2. Collaborative care versus usual care (secondary outcomes).

Outcome or subgroup title No. of studies No. of participants Statistical method Effect size
2.1 Quality of life 6   Std. Mean Difference (IV, Random, 95% CI) Subtotals only
2.1.1 Quality of life: average endpoint in physical health ‐ up to 6 months 5 406 Std. Mean Difference (IV, Random, 95% CI) 0.55 [‐0.24, 1.33]
2.1.2 Quality of life: average endpoint in physical health ‐ 12 months 3 237 Std. Mean Difference (IV, Random, 95% CI) 0.08 [‐0.18, 0.33]
2.1.3 Quality of life: average endpoint in physical health ‐ more than 12 months 2 381 Std. Mean Difference (IV, Random, 95% CI) 0.02 [‐0.19, 0.24]
2.1.4 Quality of life: average endpoint in mental health ‐ up to 6 months 5 406 Std. Mean Difference (IV, Random, 95% CI) 0.71 [‐0.17, 1.59]
2.1.5 Quality of life: average endpoint in mental health component (more than 12 months) 2 381 Std. Mean Difference (IV, Random, 95% CI) 0.30 [‐0.10, 0.70]
2.1.6 Quality of life: overall endpoint (WHOQOL‐BREF) ‐ 6 months 1 94 Std. Mean Difference (IV, Random, 95% CI) ‐0.20 [‐0.61, 0.22]
2.1.7 Quality of life: overall endpoint (WHOQOL‐BREF) ‐ 12 months 1 91 Std. Mean Difference (IV, Random, 95% CI) 0.11 [‐0.31, 0.54]
2.2 Mental state 6   Std. Mean Difference (IV, Random, 95% CI) Subtotals only
2.2.1 Mental state (overall general score) up to 6 months 1 29 Std. Mean Difference (IV, Random, 95% CI) ‐0.34 [‐1.07, 0.40]
2.2.2 Mental state (general psychopathology) 6 months 1 80 Std. Mean Difference (IV, Random, 95% CI) ‐0.11 [‐0.55, 0.33]
2.2.3 Mental state (general psychopathology) 12 months 1 253 Std. Mean Difference (IV, Random, 95% CI) ‐0.27 [‐0.53, ‐0.01]
2.2.4 Mental state (positive symptoms) 6 months 1 80 Std. Mean Difference (IV, Random, 95% CI) ‐0.04 [‐0.48, 0.40]
2.2.5 Mental state (positive symptoms) 12 months 1 253 Std. Mean Difference (IV, Random, 95% CI) ‐0.17 [‐0.43, 0.09]
2.2.6 Mental state (negative symptoms) 6 months 1 80 Std. Mean Difference (IV, Random, 95% CI) ‐0.26 [‐0.70, 0.18]
2.2.7 Mental state (negative symptoms) 12 months 1 253 Std. Mean Difference (IV, Random, 95% CI) ‐0.08 [‐0.34, 0.18]
2.2.8 Mental state (depressive symptoms) up to 6 months 4 259 Std. Mean Difference (IV, Random, 95% CI) ‐0.13 [‐0.53, 0.27]
2.2.9 Mental state (depressive symptoms) 12 months 3 227 Std. Mean Difference (IV, Random, 95% CI) ‐0.17 [‐0.53, 0.18]
2.2.10 Mental state (depressive symptoms) more than 12 months 1 75 Std. Mean Difference (IV, Random, 95% CI) ‐0.19 [‐0.64, 0.27]
2.2.11 Mental state (manic symptoms) up to 6 months 3 230 Std. Mean Difference (IV, Random, 95% CI) ‐0.14 [‐0.40, 0.12]
2.2.12 Mental state (manic symptoms) 12 months 3 227 Std. Mean Difference (IV, Random, 95% CI) ‐0.08 [‐0.38, 0.22]
2.2.13 Mental state (manic symptoms) more than 12 months 1 75 Std. Mean Difference (IV, Random, 95% CI) ‐0.36 [‐0.82, 0.10]
2.3 Psychiatric hospital admissions: number of participants admitted to hospital (greater than 12 months) 1   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
2.3.1 Number of participants admitted to hospital (in year 2) 1 306 Risk Ratio (M‐H, Fixed, 95% CI) 0.75 [0.57, 0.99]
2.3.2 Number of participants admitted to hospital (in year 3) 1 306 Risk Ratio (M‐H, Fixed, 95% CI) 0.73 [0.53, 1.01]
2.4 Other hospital admissions 2   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
2.4.1 Number of participants admitted to hospital (up to 12 months) 1 253 Risk Ratio (M‐H, Fixed, 95% CI) 7.77 [0.45, 134.42]
2.4.2 Number of participants admitted to hospital (in year 2) 1 306 Risk Ratio (M‐H, Fixed, 95% CI) 0.83 [0.65, 1.04]
2.4.3 Number of participants admitted to hospital (in year 3) 1 306 Risk Ratio (M‐H, Fixed, 95% CI) 0.70 [0.53, 0.93]
2.5 Personal recovery 0 0 Risk Ratio (M‐H, Fixed, 95% CI) Not estimable
2.6 Physical health status 3   Std. Mean Difference (IV, Random, 95% CI) Subtotals only
2.6.1 Blood pressure, mmHg systolic ‐ up to 6 months 3 165 Std. Mean Difference (IV, Random, 95% CI) ‐0.15 [‐0.54, 0.24]
2.6.2 Blood pressure, mmHg systolic ‐ 12 months 2 136 Std. Mean Difference (IV, Random, 95% CI) ‐0.20 [‐0.54, 0.13]
2.6.3 Blood pressure, mmHg systolic ‐ 24 months 1 75 Std. Mean Difference (IV, Random, 95% CI) ‐0.22 [‐0.67, 0.24]
2.6.4 Blood pressure, mmHg diastolic ‐ 6 months 2 136 Std. Mean Difference (IV, Random, 95% CI) ‐0.25 [‐0.77, 0.27]
2.6.5 Blood pressure, mmHg diastolic ‐ 12 months 2 136 Std. Mean Difference (IV, Random, 95% CI) ‐0.29 [‐0.70, 0.12]
2.6.6 Blood pressure, mmHg diastolic ‐ 24 months 1 75 Std. Mean Difference (IV, Random, 95% CI) ‐0.25 [‐0.70, 0.21]
2.6.7 Body mass index (BMI) ‐ 6 months 3 165 Std. Mean Difference (IV, Random, 95% CI) ‐0.18 [‐0.50, 0.15]
2.6.8 BMI ‐ 12 months 2 136 Std. Mean Difference (IV, Random, 95% CI) ‐0.37 [‐0.71, ‐0.03]
2.6.9 BMI ‐ 24 months 1 75 Std. Mean Difference (IV, Random, 95% CI) ‐0.35 [‐0.81, 0.11]
2.6.10 Total cholesterol ‐ 6 months 1 71 Std. Mean Difference (IV, Random, 95% CI) ‐0.43 [‐0.90, 0.04]
2.6.11 Total cholesterol ‐ 12 months 1 71 Std. Mean Difference (IV, Random, 95% CI) ‐0.19 [‐0.65, 0.28]
2.6.12 Total cholesterol ‐ 24 months 1 75 Std. Mean Difference (IV, Random, 95% CI) 0.07 [‐0.39, 0.52]
2.6.13 Triglycerides up to 6 months 1 29 Std. Mean Difference (IV, Random, 95% CI) ‐0.35 [‐1.09, 0.38]
2.6.14 High‐density lipoprotein (HDL) ‐ 6 months 1 71 Std. Mean Difference (IV, Random, 95% CI) ‐0.06 [‐0.52, 0.41]
2.6.15 High‐density lipoprotein (HDL) ‐ 12 months 1 71 Std. Mean Difference (IV, Random, 95% CI) 0.10 [‐0.36, 0.57]
2.6.16 High‐density lipoprotein (HDL) ‐ 24 months 1 75 Std. Mean Difference (IV, Random, 95% CI) ‐0.19 [‐0.64, 0.27]
2.6.17 Low‐density lipoprotein (LDL) ‐ 6 months 2 100 Std. Mean Difference (IV, Random, 95% CI) ‐0.34 [‐0.73, 0.06]
2.6.18 Low‐density lipoprotein (LDL) ‐ 12 months 1 71 Std. Mean Difference (IV, Random, 95% CI) ‐0.12 [‐0.59, 0.34]
2.6.19 Low‐density lipoprotein (LDL) ‐ 24 months 1 75 Std. Mean Difference (IV, Random, 95% CI) ‐0.00 [‐0.46, 0.45]
2.6.20 HbA1c up to 6 months 1 29 Std. Mean Difference (IV, Random, 95% CI) ‐0.37 [‐1.10, 0.37]
2.6.21 Waist circumference ‐ 6 months 2 136 Std. Mean Difference (IV, Random, 95% CI) ‐0.31 [‐0.98, 0.35]
2.6.22 Waist circumference ‐ 12 months 2 136 Std. Mean Difference (IV, Random, 95% CI) ‐0.39 [‐0.75, ‐0.03]
2.6.23 Waist circumference ‐ 24 months 1 75 Std. Mean Difference (IV, Random, 95% CI) ‐0.29 [‐0.75, 0.17]
2.7 Global state 0 0 Risk Ratio (M‐H, Fixed, 95% CI) Not estimable
2.8 Medication adherence (patient‐reported) (DAI‐10) 1   Risk Ratio (M‐H, Random, 95% CI) Subtotals only
2.8.1 Medication adherence (patient at 6 months) 1 94 Risk Ratio (M‐H, Random, 95% CI) 0.83 [0.67, 1.04]
2.8.2 Medication adherence (patient at 12 months) 1 91 Risk Ratio (M‐H, Random, 95% CI) 0.91 [0.75, 1.11]
2.9 Medication adherence (patient‐reported) (MARS) 1   Mean Difference (IV, Fixed, 95% CI) Subtotals only
2.9.1 Medication adherence (up to 6 months) 1 96 Mean Difference (IV, Fixed, 95% CI) 1.79 [1.56, 2.02]
2.10 Social functioning (binary) 1 253 Risk Ratio (M‐H, Random, 95% CI) 1.38 [0.97, 1.95]
2.11 Social functioning/disability 4   Std. Mean Difference (IV, Random, 95% CI) Subtotals only
2.11.1 Social functioning/disability (up to 6 months) 3 230 Std. Mean Difference (IV, Random, 95% CI) ‐0.14 [‐0.61, 0.32]
2.11.2 Social functioning/disability ‐ 12 months 4 480 Std. Mean Difference (IV, Random, 95% CI) ‐0.16 [‐0.44, 0.12]
2.11.3 Social functioning/disability (more than 12 months) 1 75 Std. Mean Difference (IV, Random, 95% CI) ‐0.14 [‐0.59, 0.32]
2.12 Substance use (alcohol/illicit drugs/cigarettes/tobacco) 0 0 Risk Ratio (M‐H, Fixed, 95% CI) Not estimable
2.13 Adverse effect/event(s) 0 0 Risk Ratio (M‐H, Fixed, 95% CI) Not estimable
2.14 Death 4   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
2.14.1 Number of participants that died from suicide (36 months) 1 330 Risk Ratio (M‐H, Fixed, 95% CI) 0.33 [0.01, 8.03]
2.14.2 Number of participants that died from natural causes (36 months) 1 330 Risk Ratio (M‐H, Fixed, 95% CI) 1.48 [0.62, 3.53]
2.14.3 Number of participants that died from suicide (12 months) 1 273 Risk Ratio (M‐H, Fixed, 95% CI) 0.53 [0.03, 8.30]
2.14.4 Death from natural causes (6 months) 1 35 Risk Ratio (M‐H, Fixed, 95% CI) 0.32 [0.01, 7.26]
2.14.5 Any deaths (12 months) 1 118 Risk Ratio (M‐H, Fixed, 95% CI) 5.17 [0.25, 105.42]
2.15 Service use outside of mental health (i.e. primary care, emergency services, walk‐in centres, social services) 0 0 Risk Ratio (M‐H, Fixed, 95% CI) Not estimable
2.16 Cost of treatment 1   Mean Difference (IV, Random, 95% CI) Subtotals only
2.16.1 Intervention costs (at 36 months) 1 306 Mean Difference (IV, Random, 95% CI) ‐2.98 [‐16.93, 10.97]
2.17 Cost of treatment (international dollars) 1   Mean Difference (IV, Fixed, 95% CI) 493.00 [345.41, 640.59]
2.17.1 Total costs at 12 months 1   Mean Difference (IV, Fixed, 95% CI) 493.00 [345.41, 640.59]
2.18 Experience of care/satisfaction 0 0 Risk Ratio (M‐H, Fixed, 95% CI) Not estimable
2.19 Attrition/leaving the study early 6   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
2.19.1 Attrition/leaving the study early (lost to follow‐up 6 months) 3 235 Risk Ratio (M‐H, Fixed, 95% CI) 1.39 [0.76, 2.55]
2.19.2 Attrition/leaving the study early (lost to follow‐up 12 months) 3 504 Risk Ratio (M‐H, Fixed, 95% CI) 1.11 [0.77, 1.58]
2.19.3 Attrition/leaving the study early (lost to follow‐up 24 months) 1 118 Risk Ratio (M‐H, Fixed, 95% CI) 1.19 [0.74, 1.92]
2.19.4 Attrition/leaving the study early (lost to follow‐up at 36 months) 1 330 Risk Ratio (M‐H, Fixed, 95% CI) 1.71 [0.77, 3.79]