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. 2009 Jan 21;2009(1):CD000532. doi: 10.1002/14651858.CD000532.pub2

1.6. Analysis.

Comparison 1 Direct effects, Outcome 6 PCP prescribing.

PCP prescribing
Study Study design Outcomes Results
PCP prescribing ‐ psychotropics
Ashurst 1983 Randomized controlled trial Psychotropic prescribing % on tranquilisers 
 12 months post treatment 
 Int 14.5% (n=62) 
 Con 31.9% (n=72) 
 Absolute change=‐17.4% 
 Relative % change=‐55% 
 Reported chisq=4.65, df=1, p=0.03 
 
 % on antidepressants 
 12 months post treatment 
 Int 17.1% (n=41) 
 Con 18.2% (n=55) 
 Absolute change=‐1.1% 
 Relative % change=‐6% 
 Reported chisq=0, df=1, p=1.0
Ashworth 2000 Controlled before‐after study Psychotropic prescribing Change in medication 1 year 
 Pre treatment 
 Int 30 (n=30) 
 Con 30 (n=30) 
 Post treatment 
 Int 14 (n=30) 
 Con 29 (n=30) 
 Absolute change post ‐15 
 Relative % change ‐51.7 
 Absolute change from baseline 
 Int ‐16, Con ‐1 
 Difference in absolute change from baseline ‐15 
 
 Change in medication 2 years 
 Pre 
 Int 27 (n=27) 
 Con 27 (n=27) 
 Post treatment 
 Int 16 (n=27) 
 Con 23 (n=27) 
 Absolute change post ‐7 
 Relative % change ‐30.4 
 Absolute change from baseline 
 Int ‐11, Con ‐4 
 Difference in absolute change from baseline ‐7 
 
 Change in medication 1 year comparison 2 
 Pre treatment 
 Int 30 (n=75) 
 Con 0 (n=75) 
 Post treatment 
 Int 24 (n=75) 
 Con 0 (n=75) 
 Absolute change post 24 
 Relative % change 0 
 Absolute change from baseline 
 Int ‐6, Con 0 
 Difference in absolute change from baseline ‐6 
 
 Change in medication 2 years comparison 2 
 Pre treatment 
 Int 24 (n=75) 
 Con 0 (n=75) 
 Post treatment 
 Int 27 (n=71) 
 Con 4 (n=63) 
 Absolute change post 23 
 Relative % change, 575.0 
 Absolute change from baseline 
 Int 3, Con 4, 
 Difference in absolute change from baseline ‐1
Blakey 1986 Controlled before‐after study Psychotropic prescribing Note: Data presented in form of tables only
Boot 1994 Randomized controlled trial Psychotropic prescribing Overall psychotropic prescriptions 
 6 weeks 
 Int: 17/107 (16%) 
 Con: 19/60 (32%) 
 Absolute change=‐16% 
 Relative % change=‐50% 
 Reported chisq=4.8, df=1, p=0.029 
 
 Antidepressants 
 Int: 10/107 (9%) 
 Con: 14/60 (23%) 
 Absolute change=‐14% 
 Relative % change=‐61% 
 Reported chisq=5, df=1, p=0.02 
 
 Anxiolytic prescriptions 
 Int: 6 (9%) 
 Con: 3 (8%) 
 Absolute change=1% 
 Relative % change=13% 
 Reported Fisher's exact p=0.28
Brodaty 1983 Randomized controlled trial Psychotropic prescribing Psychotropics 
 Pre‐treatment 
 Int 0.83 (0.71) (n=18) 
 Con 0.50 (0.89) (n=20) 
 No test reported 
 
 Post‐treatment 
 Int 0.94 (0.87) 
 Con 0.50 (0.69) 
 Absolute change=0.44 
 Relative % change=88% 
 Absolute change from baseline 
 Int 0.11 Con 0.0 
 Difference in absolute change in baseline=0.11 
 No test reported 
 
 12 month 
 Int 0.75 (0.86) 
 Con 0.40 (0.60) 
 Absolute change=0.35 
 Relative % change=88% 
 Absolute change from baseline 
 Int ‐0.08 Con ‐0.10 
 Difference in absolute change in baseline=0.02 
 No test reported
Brouwers 2006 Randomized controlled trial Psychotropic prescribing Prescribed psychotropic 18 months 
 Post treatment 
 Int 18.4% (n=98) 
 Con 21.9% (n=96) 
 Absolute change post ‐3.5 
 Relative % change ‐16.0 
 
 Psychotropic medication prescription 
 Post treatment 
 Int 1.1 (3.9) (n=96) 
 Con 1.4 (4.3) (n=96) 
 Absolute change post ‐0.3 
 Relative % change ‐21.4
Catalan 1991 Randomized controlled trial Psychotropic prescribing Prescriptions (absolute numbers) 
 5‐10 weeks 
 Int 1 (n=21) (5%) 
 Con 5 (n=26) (19%) 
 Absolute change=‐14% 
 Relative % change=‐74% 
 
 11‐28 weeks 
 Int 0 (n=21) (0%) 
 Con 4 (n=26) (15%) 
 Absolute change=‐15% 
 Relative % change=‐100% 
 No significance tests reported
Corney 1984 Randomized controlled trial Psychotropic prescribing Psychotropic prescribing 
 Pre‐treatment 
 Int 80.5% (n=41) 
 Con 82.1% (n=39) 
 6 months 
 Int 22% (9/41) 
 Con 31% (12/39) 
 Absolute change=‐9% 
 Relative % change=‐29% 
 Absolute change from baseline 
 Int ‐58.5% Con ‐51.1% 
 Difference in absolute change from baseline=‐7% 
 Reported n.s. 
 
 Time on psychotropic drugs 
 Int None (19.5%) 1 month (39.0%) 2‐3 months (14.6%) 4‐6 months (26.8%) (n=41) 
 Con None (17.9%), 1 month (38.5%), 2‐3 months (15.4%), 4‐6 months(28.2%) (n=39)
Corney 2003 Randomized controlled trial Psychotropic prescribing Mental health medication 12 months (data from page 46, column 1) 
 Pre treatment 
 Int 50% (n=90) 
 Con 33.7% (n=89) 
 6 months 
 Int 42.7% (n=82) 
 Con 45.6% (n=79) 
 Absolute change post ‐2.9 
 Relative % change ‐6.4 
 Absolute change from baseline 
 Int ‐7.3, Con 11.9 Difference in absolute change from baseline ‐19.2 
 12 months 
 Int 40.0% (n=75) 
 Con 38.2% (n=68) 
 Absolute change post 1.8 
 Relative % change 4.7 
 Absolute change from baseline 
 Int ‐10.0, Con 4.5 Difference in absolute change from baseline ‐14.5 
 
 Mental health medication costs 6 months 
 Pre treatment 
 Int 11 (24) 
 Con 16 (32) 
 Post treatment 
 Int 41 (38) 
 Con 40 (29) 
 Absolute change post 1 
 Relative % change 2.5 
 Absolute change from baseline 
 Int 30, Con 24 
 Difference in absolute change from baseline 6 
 
 Mental health medication costs 12 months Pre treatment 
 Int 11 (24) 
 Con 16 (32) 
 Post treatment 
 Int 50 (54) 
 Con 66 (77) 
 Absolute change post ‐16 
 Relative % change ‐24.2 
 Absolute change from baseline 
 Int 39, Con 50 
 Difference in absolute change from baseline ‐11
Earll 1982 Randomized controlled trial Psychotropic prescribing Psychotropic prescriptions 
 Post‐treatment 
 Int 39% (n=23) 
 Con 74% (n=19) 
 Absolute change=‐35% 
 Relative % change=‐47% 
 Reported p<0.05 
 
 7 month follow up 
 Int 65% (n=23) 
 Con 74% (n=19) 
 Absolute change=‐9% 
 Relative % change=‐12% 
 Reported n.s.
Gournay 1995 Randomized controlled trial Psychotropic prescribing Drugs and dispensing 
 Baseline 
 Int 4/49 (8%) 
 Con 3/46 (7%) 
 
 24 weeks 
 Int 9/49 (18%) 
 Con 11/46 (24%) 
 Absolute change=‐6% 
 Relative % difference=‐25% 
 Absolute change from baseline 
 Int 10% Con 17% 
 Difference in absolute change from baseline=‐7%
Hemmings 1997 Randomized controlled trial Psychotropic prescribing Psychotropics 
 Baseline 
 Int 34/136 (25%) 
 Con 17/52 (33%) 
 4 months 
 Int 23/114 (20%) 
 Con 13/40 (33%) 
 Absolute change=‐13% 
 Relative % change=‐39% 
 Absolute change from baseline 
 Int ‐5% Con 0% 
 Difference in absolute change in baseline =‐5% 
 Reported chisq=2.9, df=1, p=0.09 
 
 8 months 
 Int 11/76 (15%) 
 Con 5/24 (21%) 
 Absolute change=‐6% 
 Relative % change=‐29% 
 Absolute change from baseline 
 Int ‐10% Con ‐12% 
 Difference in absolute change in baseline =2% 
 Reported chisq=0.07, df=1, p=0.8
King 2000a Randomized controlled trial Psychotropic prescribing Antidepressants 12 months 
 Post treatment 
 Int 27% (n=63) 
 Con 49.3% (n=67) 
 Absolute change post ‐22.3 
 Relative % change ‐45.2 
 
 Minor tranquilisers 12 months 
 Post treatment 
 Int 6.3% (n=63) 
 Con 17.9% (n=67) 
 Absolute change post ‐11.6 
 Relative % change ‐64.8 
 
 Beta blockers 12 months 
 Post treatment 
 Int 7.9% (n=63) 
 Con 4.5% (n=67) 
 Absolute change post 3.4 
 Relative % change 75.6 
 
 Major tranquilisers 12 months 
 Post treatment 
 Int 0% (n=63) 
 Con 0% (n=67) 
 Absolute change post 0 
 Relative % change NA 
 
 Medication costs 12 months 
 Post treatment 
 Int 12.2 (37.5) (n=63) 
 Con 40.7 (77.8) (n=67) 
 Absolute change post ‐28.5 
 Relative % change ‐70.0
King 2000b Randomized controlled trial Psychotropic prescribing Antidepressants 12 months 
 Post treatment 
 Int 29.9% (n=67) 
 Con 49.3% (n=67) 
 Absolute change post ‐19.4 
 Relative % change ‐39.4 
 
 Minor tranquilisers 12 months 
 Post treatment 
 Int 14.9% (n=67) 
 Con 17.9% (n=67) 
 Absolute change post ‐3 
 Relative % change ‐16.8 
 
 Beta blockers 12 months 
 Post treatment 
 Int 3% (n=67) 
 Con 4.5% (n=67) 
 Absolute change post ‐1.5 
 Relative % change ‐33.3 
 
 Major tranquilisers 12 months 
 Post treatment 
 Int 1.5% (n=67) 
 Con 0% (n=67) 
 Absolute change post 1.5 
 Relative % change NA 
 
 Medication costs 12 months 
 Post treatment 
 Int 24.1(54.2) (n=67) 
 Con 40.7 (77.8) (n=67) 
 Absolute change post ‐16.6 
 Relative % change ‐40.8
Lyon 1993 Controlled before‐after study Psychotropic prescribing Tranquilisers (numbers of patients) 
 3m pre‐treatment 
 Int 6/38 (16%) 
 Con 7/33 (21%) 
 
 3 months post treatment 
 Int 3/38 (8%) 
 Con 6/33 (18%) 
 Absolute change=‐10% 
 Relative % change=‐56% 
 Absolute change from baseline 
 Int ‐8% Con ‐3% 
 Difference in absolute change from baseline=‐5% 
 
 Antidepressants 
 Pre‐treatment 
 Int 3/38 (8%) 
 Con 0/33 (0%) 
 
 3 months post‐treatment 
 Int 4/38 (11%) 
 Con 8/33 (24%) 
 Absolute change=‐13% 
 Relative % change=‐54% 
 Absolute change from baseline 
 Int 3% Con 24% 
 Difference in absolute change from baseline=‐21%
Martin 1985 Controlled before‐after study Psychotropic prescribing Psychotropic prescriptions 
 12 months pre‐treatment 
 Int 1.86 
 Con 0.62 
 
 12 months post‐treatment 
 Int 2.91 
 Con 0.64 
 Absolute change=2.27 
 Relative % change=355% 
 Absolute change from baseline 
 Int 1.05 Con 0.02 
 Difference in absolute change from baseline=1.03
Mynors‐Wallis 1997 Randomized controlled trial Psychotropic prescribing Cost of medications 
 During treatment 
 Int £3.8 (9.0) (n=40) 
 Con £6.8 (11.9) (n=30) 
 Absolute change=‐£3.0 
 Relative % change=‐44% 
 Reported p=0.251 
 
 Cost of medications 
 4 months post‐treatment 
 Int £2.5 (6.6) (n=40) 
 Con £13.3 (23.3) (n=30) 
 Absolute change=‐£10.8 
 Relative % change=‐81% 
 Reported p=0.008 
 
 Cost of medications (from entry) 
 Int £6.4 (12.8) (n=40) 
 Con £20.1 (31.7) (n=30) 
 Absolute change=‐13.7 
 Relative % change=‐68% 
 Reported p=0.018
Robson 1984 Randomized controlled trial Psychotropic prescribing Prescribing (category A ‐ psychotropics) 
 3 months 
 Int £2.00 
 Con £4.10 
 Absolute change=‐£2.1 
 Relative % change=‐51% 
 Reported p=0.004 
 
 6 months 
 Int £3.77 
 Con £6.34 
 Absolute change=‐£2.57 
 Relative % change=‐41% 
 Reported p=0.02 
 
 12 months 
 Int £5.63 
 Con £9.69 
 Absolute change=‐£4.06 
 Relative % change=‐42% 
 Reported p=0.01
Stanton 1998 Randomized controlled trial Psychotropic prescribing Psychotropics prescribed 
 6 months 
 Int 0 (65%) 1+ (22%) Missing (13%) (n=23) 
 Con 0 (50%) 1+ (33%) Missing (17%) (n=24) 
 Absolute change=‐11% 
 Relative % change=‐33% 
 No tests
Teasdale 1984 Randomized controlled trial Psychotropic prescribing Antidepressant medication 
 Baseline 
 Int 11/17 (65%) 
 Con 10/17 (59%) 
 Post‐treatment 
 Int (increase) 0 (same) 3 (decrease) 3 (none) 5 (% medication = 6/17=35%) 
 Con (increase) 2 (same) 3 (decrease) 1 (none) 4 (% medication = 6/17=35%) 
 Absolute change=0% 
 Relative % change=0% 
 Absolute change from baseline 
 Int ‐30% Con ‐24% 
 Difference in absolute change from baseline=‐6% 
 
 3 months 
 Int (increase) 0 (same) 4 (decrease) 2 (none) 5 (% medication = 6/17=35%) 
 Con (increase) 1 (same) 4 (decrease) 0 (none) 5 (% medication = 5/17=29%) 
 Absolute change=6% 
 Relative % change=9% 
 Absolute change from baseline 
 Int ‐30% Con ‐30% 
 Difference in absolute change from baseline=0 
 No tests reported
PCP prescribing ‐ non‐psychotropic or combined prescribing
Brodaty 1983 Randomized controlled trial Combined prescribing Total tablet types 
 Pre‐treatment 
 Int 3.06 (1.86) (n=18) 
 Con 2.35 (1.76) (n=20) 
 No test reported 
 
 Post‐treatment 
 Int 3.00 (2.03) 
 Con 2.05 (1.57) 
 Absolute change=0.95 
 Relative % change=46% 
 Absolute change from baseline 
 Int ‐0.06 Con ‐0.30 
 Difference in absolute change 
 from baseline=0.24 
 No test reported 
 
 12 month 
 Int 3.19 (1.91) 
 Con 2.05 (1.99) 
 Absolute change=1.14 
 Relative % change=56% 
 Absolute change from baseline 
 Int 0.13 Con ‐0.30 
 Difference in absolute change from 
 baseline=0.43 
 No test reported
Brouwers 2006 Randomized controlled trial Non psychotropic prescribing Prescribed non‐psychotropic 18 months 
 Post treatment 
 Int 60.2% (n=98) 
 Con 50% (n=96) 
 Absolute change post 10.2 
 Relative % change 20.4 
 
 Non‐psychotropic medication prescription 
 Post treatment 
 Int 4.4 (7.5) (n=96) 
 Con 3.9 (7.1) (n=96) 
 Absolute change post 0.5 
 Relative % change 12.8
Corney 2003 Randomized controlled trial Combined prescribing Medication 6 months 
 Pre treatment 
 Int 49.5% (n=91) 
 Con 34.8% (n=89) 
 
 Post treatment 
 Int 42.7% (n=82) 
 Con 45.6% (n=79) 
 Absolute change Post treatment ‐2.9 
 Relative % change ‐6.4 
 Absolute change from baseline 
 Int ‐6.8, Con 10.8 
 Difference in absolute change 
 from baseline ‐17.6 
 
 Medication 12 months 
 Pre treatment 
 Int 49.5% (n=91) 
 Con 34.8% (n=89) 
 Post treatment 
 Int 40% (n=75) 
 Con 42.6% (n=68) 
 Absolute change Post treatment‐2.6 
 Relative % change ‐6.1 
 Absolute change from baseline 
 Int ‐9.5, Con 7.8 
 Difference in absolute change 
 from baseline ‐17.3
Earll 1982 Randomized controlled trial Non‐psychotropic prescribing Other medication 
 Post‐treatment 
 Int 61% (n=23) 
 Con 42% (n=19) 
 Absolute change=19% 
 Relative % change=45% 
 Reported n.s. 
 
 7 months 
 Int 87% (n=23) 
 Con 63% (n=19) 
 Absolute change=24% 
 Relative % change=38% 
 Reported n.s.
Ginsberg 1984 Randomized controlled trial Combined prescribing Costs of drugs and dispensing 
 12 months pre‐treatment 
 Int £12.45 (n=22) 
 Con £6.27 (n=26) 
 
 12 months post‐treatment 
 Int £9.75 (n=22) 
 Con £6.33 (n=26) 
 Absolute change=£3.42 
 Relative % change=54% 
 Absolute change from baseline 
 Int ‐£2.7 Con £0.06 
 Difference in absolute change from baseline=‐£2.76 
 Reported n.s.
Harvey 1998 Randomized controlled trial Combined prescribing Mean costs of drugs prescribed 
 Int £10.97 
 Con £25.38 
 Absolute change=‐£14.41 
 Relative % change=‐57% 
 No s.d. or tests
Kendrick 2005a Randomized controlled trial Combined prescribing Medication costs 26 weeks 
 Post treatment 
 Int 36 (53) (n=62) 
 Con 44 (51) (n=51) 
 Absolute change Post treatment ‐8 
 Relative % change ‐18.2
Kendrick 2005b Randomized controlled trial Combined prescribing Medication costs 26 weeks 
 Post treatment 
 Int 40 (74) (n=71) 
 Con 44(51) (n=51) 
 Absolute change Post treatment ‐4 
 Relative % change ‐9.1
Richards 2003 Randomized controlled trial Combined prescribing Medication costs 12 months 
 Post treatment 
 Int 70.79 (127.32) (n=47) 
 Con 109.03 (134.62) (n=40) 
 Absolute change Post treatment ‐38.24 
 Relative % change ‐35.1 
 Mean difference ‐38.24, 
 95% CI ‐94.15 to 17.68, p=0.178
Robson 1984 Randomized controlled trial Non‐psychotropic prescribing Prescribing (category B ‐ nutritional, 
 blood and skin) 
 3 months 
 Int £0.60 
 Con £0.60 
 Absolute change=£0 
 Relative % change=0 
 Reported p=0.9 
 
 6 months 
 Int £1.13 
 Con £1.17 
 Absolute change=‐£0.04 
 Relative % change=‐3% 
 Reported p=0.9 
 
 12 months 
 Int £2.36 
 Con £2.03 
 Absolute change=£0.33 
 Relative % change=16% 
 Reported p=0.7 
 
 Prescribing 
 (category C ‐ all other drugs) 
 3 months 
 Int £1.90 
 Con £2.20 
 Absolute change=‐£0.30 
 Relative % change=‐14% 
 Reported p=0.5 
 
 6 months 
 Int £4.23 
 Con £4.61 
 Absolute change=‐£0.38 
 Relative % change=‐8% 
 Reported p=0.7 
 
 12 months 
 Int £8.75 
 Con £9.69 
 Absolute change=£0.94 
 Relative % change=‐10% 
 Reported p=0.7