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Referral to a new psychological therapy service is associated with reduced utilisation of healthcare and sickness absence by people with common mental health problems: a before and after comparison

Referral to a new psychological therapy service is associated with reduced utilisation of healthcare and sickness absence by people with common mental health problems: a before and after comparison
Referral to a new psychological therapy service is associated with reduced utilisation of healthcare and sickness absence by people with common mental health problems: a before and after comparison
Background: Improving Access to Psychological Therapies (IAPT) is a new programme designed to reduce disease burden to the individual and economic burden to the society of common mental health problems (CMHP). This is the first study to look at the impact of IAPT on health service utilisation and sickness absence using routine data.

Method: The authors used pseudonymised secure and privately linked (SAPREL) routinely collected primary, secondary care and clinic computer data from two pilot localities. The authors explored antidepressant prescribing, accident and emergency and outpatients attendances, inpatient stays, bed days, and sick certification. The authors compared the registered population with those with CMHP. The authors then made a 6?months before and after comparison of people referred to IAPT with age–sex and practice-matched controls.

Results: People with CMHP used more health resources than those without CMHP: more prescriptions of antidepressants 5.25 (95% CI 5.38 to 5.13), inpatient episodes 4.89 (95% CI 5.0 to 4.79), occupied bed days 1.25 (95% CI 0.95 to 1.55), outpatient 1.5 (95% CI 1.40 to 1.63) and emergency department attendances 0.34 (95% CI 0.31 to 0.37), and medical certificates 0.29 (95% CI 0.26 to 0.32). Comparison of service utilisation 6?months before and after referral to IAPT was associated with reduced use of emergency department attendances (mean difference: 0.12 (95% CI 0.06 to 0.19, p<0.001)). However, the number of prescriptions of antidepressants increased mean difference ?0.15 (95% CI 0.02?0.29, p=0.028).

Conclusions: People with CMHP use more healthcare resources. Referral to the IAPT programme is associated with a subsequent reduction in emergency department attendances, sickness certification and improved adherence to drug treatment.

0143-005X
e10-e10
de Lusignan, S.
67a36f6c-26a8-450b-9603-ba28bbca01fa
Chan, T.
5dd3d19b-381c-42f0-8d65-403a46b2b87b
Parry, G.
360bf88a-fb8b-44d6-b2f4-acfd2e0ee9c1
Dent-Brown, K.
55542f62-3fee-4589-a402-8bf8c2f4d985
Kendrick, T.
c697a72c-c698-469d-8ac2-f00df40583e5
de Lusignan, S.
67a36f6c-26a8-450b-9603-ba28bbca01fa
Chan, T.
5dd3d19b-381c-42f0-8d65-403a46b2b87b
Parry, G.
360bf88a-fb8b-44d6-b2f4-acfd2e0ee9c1
Dent-Brown, K.
55542f62-3fee-4589-a402-8bf8c2f4d985
Kendrick, T.
c697a72c-c698-469d-8ac2-f00df40583e5

de Lusignan, S., Chan, T., Parry, G., Dent-Brown, K. and Kendrick, T. (2012) Referral to a new psychological therapy service is associated with reduced utilisation of healthcare and sickness absence by people with common mental health problems: a before and after comparison. Journal of Epidemiology & Community Health, 66 (6), e10-e10. (doi:10.1136/jech.2011.139873).

Record type: Article

Abstract

Background: Improving Access to Psychological Therapies (IAPT) is a new programme designed to reduce disease burden to the individual and economic burden to the society of common mental health problems (CMHP). This is the first study to look at the impact of IAPT on health service utilisation and sickness absence using routine data.

Method: The authors used pseudonymised secure and privately linked (SAPREL) routinely collected primary, secondary care and clinic computer data from two pilot localities. The authors explored antidepressant prescribing, accident and emergency and outpatients attendances, inpatient stays, bed days, and sick certification. The authors compared the registered population with those with CMHP. The authors then made a 6?months before and after comparison of people referred to IAPT with age–sex and practice-matched controls.

Results: People with CMHP used more health resources than those without CMHP: more prescriptions of antidepressants 5.25 (95% CI 5.38 to 5.13), inpatient episodes 4.89 (95% CI 5.0 to 4.79), occupied bed days 1.25 (95% CI 0.95 to 1.55), outpatient 1.5 (95% CI 1.40 to 1.63) and emergency department attendances 0.34 (95% CI 0.31 to 0.37), and medical certificates 0.29 (95% CI 0.26 to 0.32). Comparison of service utilisation 6?months before and after referral to IAPT was associated with reduced use of emergency department attendances (mean difference: 0.12 (95% CI 0.06 to 0.19, p<0.001)). However, the number of prescriptions of antidepressants increased mean difference ?0.15 (95% CI 0.02?0.29, p=0.028).

Conclusions: People with CMHP use more healthcare resources. Referral to the IAPT programme is associated with a subsequent reduction in emergency department attendances, sickness certification and improved adherence to drug treatment.

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More information

Published date: October 2012
Organisations: Primary Care & Population Sciences

Identifiers

Local EPrints ID: 353907
URI: http://eprints.soton.ac.uk/id/eprint/353907
ISSN: 0143-005X
PURE UUID: 9e7110c1-93da-449c-a71f-7d9b54955405
ORCID for T. Kendrick: ORCID iD orcid.org/0000-0003-1618-9381

Catalogue record

Date deposited: 24 Jun 2013 15:42
Last modified: 09 Nov 2021 02:56

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Contributors

Author: S. de Lusignan
Author: T. Chan
Author: G. Parry
Author: K. Dent-Brown
Author: T. Kendrick ORCID iD

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