On-site mental health workers delivering psychological therapy and psychosocial interventions to patients in primary care: effects on the professional practice of primary care providers

Harkness, Elaine; Bower, Peter

doi:10.1002/14651858.cd000532.pub2

Cited by 55 publications

(46 citation statements)

References 196 publications

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“…For example, a 2009 Cochrane review concluded that any reduction in prescribing that occurred when individuals had access to psychological therapy did not generalise to the wider practice population/community. 15 This finding is corroborated by other primary studies. 27,28 A recent economic evaluation of an IAPT demonstration site found that IAPT provided a service that was 'probably costeffective' within the usual NICE threshold range of £20 000-£30 000, although with considerable uncertainty surrounding the costs and outcome differences.…”

Section: Comparison With Existing Literaturesupporting

confidence: 82%

“…A 2009 Cochrane review concluded that mental health workers working in primary care to deliver psychological therapy caused a significant reduction in GP consultations, prescribing, and secondary care referrals, although the changes were modest, inconsistent, and did not generalise to the wider patient population. 15 The aim of this study was to investigate the impact of the establishment of IAPT services on antidepressant prescribing rates in PCTs in England. Prescription data were obtained from the NHS Information Centre iView website.…”

Section: Resultsmentioning

confidence: 99%

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Improving Access to Psychological Therapies and antidepressant prescribing rates in England: a longitudinal time-series analysis

Sreeharan

Madden²,

Lee³

et al. 2013

Br J Gen Pract

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BackgroundAntidepressant prescribing rates in England have been increasing since the 1970s. The impact of the Improving Access to Psychological Therapies (IAPT) initiative on antidepressant prescribing rates is unknown. AimTo investigate the impact of the establishment of IAPT services on antidepressant prescribing rates in primary care trusts (PCTs) in England. Design and settingA longitudinal time-series analysis, using PCTlevel data from 2008 to 2011 set in England. MethodA time-series analysis was conducted using PCT-level prescription data, dates of establishment of IAPT services, and covariate data for age, sex, and socioeconomic status. Statistical analysis was carried out using analysis of variance and a random-effect negative binomial model. ResultsAntidepressant prescribing rates in England increased by 10% per year during the study period (adjusted rate ratio = 1.10, 95% CI = 1.09 to 1.10). The implementation of IAPT services had no significant effect on antidepressant prescribing (adjusted rate ratio = 0.99, 95% CI = 0.99 to 1.00). ConclusionIntroduction of a large-scale initiative to increase provision of psychological therapies has not curbed the long-term increased prescribing of antidepressants in England. Keywordsantidepressive agents; cognitive behavioural therapy; depression; general practice; primary health care.

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Section: Comparison With Existing Literaturesupporting

confidence: 82%

Section: Resultsmentioning

confidence: 99%

Improving Access to Psychological Therapies and antidepressant prescribing rates in England: a longitudinal time-series analysis

Sreeharan

Madden²,

Lee³

et al. 2013

Br J Gen Pract

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“…Psychology can offer a significant contribution to the reduction of healthcare expenditures, as well as to the progressive improvement of the health status of the population (15). In research conducted by Harkness and Bower (16), the inclusion of mental health professionals in primary health care was found to lead Introdução É consensual que as benzodiazepinas causam dependência e tolerância com o uso prolongado (1). Ademais, este tipo de utilização provoca efeitos secundários, desde a simples sonolência diurna até à diminuição de funções cognitivas, perda de memória e desequilíbrio (2).…”

Section: Introductionunclassified

The benzodiazepines use and psychological intervention in a Porto health center

Regalado

Rocha

Duarte

et al. 2017

BBR

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161 Biomedical and Biopharmaceutical Research J o r n a l d e I n v e s t i g a ç ã o B i o m é d i c a e B i o f a r m a c ê u t i c a The benzodiazepines use and psychological intervention in a Porto health center AbstractThe misuse of benzodiazepines is a well know public health problem. For this reason, it is more and more relevant to monitor misuse and try to implement solutions. We aim to understand the use of benzodiazepines in a health center population in the city of Porto, as well the connections with present, past and future psychological intervention. We have built a questionnaire to assess usage of both benzodiazepines and psychological services. Our sample population included individuals older than 18 years who picked up our questionnaire in health center waiting rooms. A total of 352 participants, 258 females and 92 males, answered the questionnaire.Results points to an excessive use of benzodiazepines, especially in older persons, divorced or widowed, and females. We found a significant association between the current interest in receiving psychological intervention and the use of benzodiazepines. In the same way, the participants who have received psychological intervention use benzodiazepines less in comparison to the participants who are still receiving psychological intervention. In conclusion, there is an abuse of benzodiazepines in this health center, and few access to psychological intervention that may have good results reducing benzodiazepines abuse. Keywords: psychological intervention; benzodiazepines; primary health careResumo O uso inadequado de benzodiazepinas é um problema de saúde pública bem conhecido e, por isso, é particularmente relevante a sua monitorização e a implementação de soluções adequadas. Pretendemos conhecer a realidade dos utentes de um Centro de Saúde na Cidade do Porto relativamente ao consumo de benzodiazepinas, bem como a sua relação com o acompanhamento psicológico passado, atual ou futuro por parte dos mesmos. Foi construído um inquérito por questionário. Foi aplicado a indivíduos com mais de 18 anos nas salas de espera do Centro de Saúde. Responderam ao questionário 352 participantes, dos quais 258 mulheres e 92 homens. Os resultados obtidos apontam para um consumo excessivo de benzodiazepinas com predominância nas pessoas com mais idade, divorciadas ou viúvas, e do sexo feminino. Verificou-se uma associação significativa entre o interesse atual em ter acompanhamento psicológico e o consumo de benzodiazepinas. Os utentes que beneficiaram de acompanhamento psicológico consomem menos benzodiazepinas, quando comparados com os que ainda estão em acompanhamento. Em conclusão, pode salientar-se que existe um consumo desproporcionado de benzodiazepinas nos cuidados de saúde primários, havendo um acesso reduzido à intervenção psicológica que pode apresentar bons resultados ao nível da redução da utilização destes fármacos.Palavras-chave: acompanhamento psicológico; benzodiazepinas; cuidados de saúde primários

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“…10,11 Likewise, active participation in postgraduate GP training has been associated with more positive patient experiences of care. 12 Collaborative care and new structures for working together across the borders of primary and secondary care may reveal new opportunities for responding adequately to the needs of adolescents.…”

mentioning

confidence: 99%

Improving the care of adolescents in general practice

Lundstrøm

2014

Br J Gen Pract

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On-site mental health workers delivering psychological therapy and psychosocial interventions to patients in primary care: effects on the professional practice of primary care providers

Abstract: On-site mental health workers delivering psychological therapy and psychosocial interventions to patients in primary care: e ects on the professional practice of primary care providers (Review)

Cited by 55 publications

References 196 publications

Improving Access to Psychological Therapies and antidepressant prescribing rates in England: a longitudinal time-series analysis

Improving Access to Psychological Therapies and antidepressant prescribing rates in England: a longitudinal time-series analysis

The benzodiazepines use and psychological intervention in a Porto health center

Improving the care of adolescents in general practice

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