The University of Southampton
University of Southampton Institutional Repository

Referral for psychological therapy of people with long term conditions improves adherence to antidepressants and reduces emergency department attendance: controlled before and after study

Referral for psychological therapy of people with long term conditions improves adherence to antidepressants and reduces emergency department attendance: controlled before and after study
Referral for psychological therapy of people with long term conditions improves adherence to antidepressants and reduces emergency department attendance: controlled before and after study
Background: referral to psychological therapies is recommended for people with common mental health problems (CMHP) however its impact on healthcare utilisation in people with long term conditions (LTCs) is not known.

Method: routinely collected primary care, psychological therapy clinic and hospital data were extracted for the registered population of 20 practices (N = 121199). These data were linked using the SAPREL (Secure and Private Record Linkage) method. We linked the 1118 people referred to psychological therapies with 6711 controls, matched for age, gender and practice. We compared utilisation of healthcare resources by people with LTCs, 6 months before and after referral, and conducted a controlled before and after study to compare health utilisation with controls. We made the assumption that collection of a greater number of repeat prescriptions for antidepressants was associated with greater adherence.

Results: overall 21.8% of people with an LTC had CMHP vs. 18.8% without (p < 0.001). People with LTCs before referral were more likely to use health care resources (2-tailed t-test p < 0.001). Cases with LTCs showed referral to the psychological therapies clinic was associated with increased antidepressant medication prescribing (mean differences 0.62, p < 0.001) and less use of emergency department than controls (mean difference ?0.21, p = 0.003).

Conclusions: referral to improved access to psychological therapies (IAPT) services appears of value to people with LTC. It is associated with the issue of a greater number of prescriptions for anti-depressant medicines and less use of emergency services. Further studies are needed to explore bed occupancy and outpatient attendance
0005-7967
377-385
de Lusignan, Simon
d3a4897a-91dd-4880-b273-f92c2fe6c42f
Chan, Tom
ec5cfb49-0fd8-4aca-b485-8baec9081dd1
Tejerina Arreal, Maria C.
7bcd6025-1f63-4e44-98a3-7c71861480f5
Parry, Glenys
1a31023a-92f2-4b12-96e6-61c83409d10b
Dent -Brown, Kim
ffee24d8-83eb-4500-830a-3a1c5806ce2b
Kendrick, Tony
c697a72c-c698-469d-8ac2-f00df40583e5
de Lusignan, Simon
d3a4897a-91dd-4880-b273-f92c2fe6c42f
Chan, Tom
ec5cfb49-0fd8-4aca-b485-8baec9081dd1
Tejerina Arreal, Maria C.
7bcd6025-1f63-4e44-98a3-7c71861480f5
Parry, Glenys
1a31023a-92f2-4b12-96e6-61c83409d10b
Dent -Brown, Kim
ffee24d8-83eb-4500-830a-3a1c5806ce2b
Kendrick, Tony
c697a72c-c698-469d-8ac2-f00df40583e5

de Lusignan, Simon, Chan, Tom, Tejerina Arreal, Maria C., Parry, Glenys, Dent -Brown, Kim and Kendrick, Tony (2013) Referral for psychological therapy of people with long term conditions improves adherence to antidepressants and reduces emergency department attendance: controlled before and after study. Behaviour Research and Therapy, 51 (7), 377-385. (doi:10.1016/j.brat.2013.03.004). (PMID:23639304)

Record type: Article

Abstract

Background: referral to psychological therapies is recommended for people with common mental health problems (CMHP) however its impact on healthcare utilisation in people with long term conditions (LTCs) is not known.

Method: routinely collected primary care, psychological therapy clinic and hospital data were extracted for the registered population of 20 practices (N = 121199). These data were linked using the SAPREL (Secure and Private Record Linkage) method. We linked the 1118 people referred to psychological therapies with 6711 controls, matched for age, gender and practice. We compared utilisation of healthcare resources by people with LTCs, 6 months before and after referral, and conducted a controlled before and after study to compare health utilisation with controls. We made the assumption that collection of a greater number of repeat prescriptions for antidepressants was associated with greater adherence.

Results: overall 21.8% of people with an LTC had CMHP vs. 18.8% without (p < 0.001). People with LTCs before referral were more likely to use health care resources (2-tailed t-test p < 0.001). Cases with LTCs showed referral to the psychological therapies clinic was associated with increased antidepressant medication prescribing (mean differences 0.62, p < 0.001) and less use of emergency department than controls (mean difference ?0.21, p = 0.003).

Conclusions: referral to improved access to psychological therapies (IAPT) services appears of value to people with LTC. It is associated with the issue of a greater number of prescriptions for anti-depressant medicines and less use of emergency services. Further studies are needed to explore bed occupancy and outpatient attendance

Full text not available from this repository.

More information

Published date: July 2013
Organisations: Primary Care & Population Sciences

Identifiers

Local EPrints ID: 354272
URI: https://eprints.soton.ac.uk/id/eprint/354272
ISSN: 0005-7967
PURE UUID: f075c9d8-a673-4523-a3fa-cb4ad5523cbb
ORCID for Tony Kendrick: ORCID iD orcid.org/0000-0003-1618-9381

Catalogue record

Date deposited: 05 Jul 2013 11:02
Last modified: 20 Jul 2019 01:12

Export record

Altmetrics

Contributors

Author: Simon de Lusignan
Author: Tom Chan
Author: Maria C. Tejerina Arreal
Author: Glenys Parry
Author: Kim Dent -Brown
Author: Tony Kendrick ORCID iD

University divisions

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of https://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×