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 |