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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

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
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
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%) (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 higher in 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.
cost-effectiveness referral, community mental health nurses, general practitioner care, common mental disorders, problem-solving treatment
0007-1250
50-59
Kendrick, T.
c697a72c-c698-469d-8ac2-f00df40583e5
Simons, L.
894baef5-52f4-4979-9684-1c082b624752
Mynors-Wallis, L.
4e619551-9684-4113-983b-6644fa933ff8
Gray, A.
78549c1f-9ceb-4028-846f-8e26f6947852
Lathlean, J.
98a74375-c265-47d2-b75b-5f0f3e14c1a9
Pickering, R.
4a828314-7ddf-4f96-abed-3407017d4c90
Harris, S.
19ea097b-df15-4f0f-be19-8ac42c190028
Rivero-Arias, O.
e8f56699-ff2b-4dde-acf0-b9cbb9025ea9
Gerard, K.
ce7b5859-1c5f-4e9f-b5ba-acbd68d0f90e
Thompson, C.
10784aa4-0fd2-42d4-8c1d-db11eb86e5a2
Kendrick, T.
c697a72c-c698-469d-8ac2-f00df40583e5
Simons, L.
894baef5-52f4-4979-9684-1c082b624752
Mynors-Wallis, L.
4e619551-9684-4113-983b-6644fa933ff8
Gray, A.
78549c1f-9ceb-4028-846f-8e26f6947852
Lathlean, J.
98a74375-c265-47d2-b75b-5f0f3e14c1a9
Pickering, R.
4a828314-7ddf-4f96-abed-3407017d4c90
Harris, S.
19ea097b-df15-4f0f-be19-8ac42c190028
Rivero-Arias, O.
e8f56699-ff2b-4dde-acf0-b9cbb9025ea9
Gerard, K.
ce7b5859-1c5f-4e9f-b5ba-acbd68d0f90e
Thompson, C.
10784aa4-0fd2-42d4-8c1d-db11eb86e5a2

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).

Record type: Article

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%) (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 higher in 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.

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More information

Published date: July 2006
Keywords: cost-effectiveness referral, community mental health nurses, general practitioner care, common mental disorders, problem-solving treatment

Identifiers

Local EPrints ID: 40560
URI: http://eprints.soton.ac.uk/id/eprint/40560
ISSN: 0007-1250
PURE UUID: d9c432df-458f-4469-9e9d-5fad66eb9b38
ORCID for T. Kendrick: ORCID iD orcid.org/0000-0003-1618-9381

Catalogue record

Date deposited: 05 Jul 2006
Last modified: 16 Mar 2024 03:00

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Contributors

Author: T. Kendrick ORCID iD
Author: L. Simons
Author: L. Mynors-Wallis
Author: A. Gray
Author: J. Lathlean
Author: R. Pickering
Author: S. Harris
Author: O. Rivero-Arias
Author: K. Gerard
Author: C. Thompson

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