Cost-effectiveness of referral for generic care or problem-solving treatment from community mental health nurses, compared with usual general practitioner care for common mental disorders: randomised control trial
Kendrick, T., Simons, L., Mynors-Wallis, L., Gray, A., Lathlean, J., Pickering, R., Harris, S., Rivero-Arias, O., Gerard, K. and Thompson, C. (2006) Cost-effectiveness of referral for generic care or problem-solving treatment from community mental health nurses, compared with usual general practitioner care for common mental disorders: randomised control trial. British Journal of Psychiatry, 189, (1), 50-59. (doi:10.1192/bjp.bp.105.012435).
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Description/Abstract
Background UK general practitioners (GPs) refer patients with common mental disorders to community mental health nurses.
Aims To determine the effectiveness and cost-effectiveness of this practice.
Method Randomised trial with three arms: usual GP care, generic mental health nurse care, and care from nurses trained in problem-solving treatment; 98 GPs in 62 practices referred 247 adult patients with new episodes of anxiety, depression and life difficulties, to 37 nurses.
Results There were 212 (86%) and190 (77%) patients followed up at 8 and 26 weeks respectively. No significant differences between groups were found in effectiveness at either point. Mean differences in Clinical Interview Schedule - Revised scores at 26 weeks compared with GP care were -1.4 (95% CI -5.5 to 2.8) for generic nurse care, and 1.1 (-2.9 to 5.1) for nurse problem-solving. Satisfaction was significantly higherin both nurse-treated groups. Mean extra costs per patient were £283 (95% CI154-411) for generic nurse care, and £315 (183-481) for nurse problem-solving treatment.
Conclusions GPs should not refer unselected patients with common mental disorders to specialist nurses. Problem-solving should be reserved for patients who have not responded to initial GP care.
| Item Type: | Article |
|---|---|
| ISSNs: | 0007-1250 (print) |
| Related URLs: | |
| Keywords: | cost-effectiveness referral, community mental health nurses, general practitioner care, common mental disorders, problem-solving treatment |
| Subjects: | R Medicine > RT Nursing R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry R Medicine > RM Therapeutics. Pharmacology |
| Divisions: | University Structure - Pre August 2011 > Superseded (SONM) > Superseded (HSR) University Structure - Pre August 2011 > School of Medicine > Community Clinical Sciences |
| Item ID: | 40560 |
| Date Deposited: | 05 Jul 2006 |
| Last Modified: | 01 Jun 2011 04:34 |
| Contributors: | Kendrick, T. (Author) Simons, L. (Author) Mynors-Wallis, L. (Author) Gray, A. (Author) Lathlean, J. (Author) Pickering, R. (Author) Harris, S. (Author) Rivero-Arias, O. (Author) Gerard, K. (Author) Thompson, C. (Author) |
| Date: | July 2006 |
| Status: | Published |
| Contact Email Address: | A.R.Kendrick@soton.ac.uk |
| URI: | http://eprints.soton.ac.uk/id/eprint/40560 |
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