Effectiveness of collaborative care in reducing suicidal ideation: An individual participant data meta-analysis

Christos Grigoroglou; Christina van der Feltz-Cornelis; Alexander Hodkinson; Peter A Coventry; Salwa S Zghebi; Evangelos Kontopantelis; Peter Bower; Karina Lovell; Simon Gilbody; Waquas Waheed; Christopher Dickens; Janine Archer; Amy Blakemore; David A Adler; Enric Aragones; Cecilia Björkelund; Martha L Bruce; Marta Buszewicz; Robert M Carney; Martin G Cole; Karina W Davidson; Jochen Gensichen; Nancy K Grote; Joan Russo; Klaas Huijbregts; Jeff C Huffman; Marco Menchetti; Vikram Patel; David A Richards; Bruce Rollman; Annet Smit; Moniek C Zijlstra-Vlasveld; Kenneth B Wells; Thomas Zimmermann; Jurgen Unutzer; Maria Panagioti

doi:10.1016/j.genhosppsych.2021.04.004

Effectiveness of collaborative care in reducing suicidal ideation: An individual participant data meta-analysis

Christos Grigoroglou
, Christina van der Feltz-Cornelis
, Alexander Hodkinson
, Peter A Coventry
, Salwa S Zghebi
, Evangelos Kontopantelis
, Peter Bower
, Karina Lovell
, Simon Gilbody
, Waquas Waheed
, Christopher Dickens
, Janine Archer
, Amy Blakemore
, David A Adler
, Enric Aragones
, Cecilia Björkelund
, Martha L Bruce
, Marta Buszewicz
, Robert M Carney
, Martin G Cole

Karina W Davidson, Jochen Gensichen, Nancy K Grote, Joan Russo, Klaas Huijbregts, Jeff C Huffman, Marco Menchetti, Vikram Patel, David A Richards, Bruce Rollman, Annet Smit, Moniek C Zijlstra-Vlasveld, Kenneth B Wells, Thomas Zimmermann, Jurgen Unutzer, Maria Panagioti

University of York
Institut Universitari d'Investigació en Atenció Primària Jordi Gol
University of Gothenburg
The Geisel School of Medicine at Dartmouth
King's College London
Washington University in St Louis
McGill University
Feinstein Institute for Medical Research
Ludwig-Maximilians-Universitat Munchen University of Munich
Harvard Medical School
Universita Degli Studi Bologna
University of Pittsburgh
HAN University of Applied Sciences
ZonMw (The Netherlands Organisation for Health Research and Development)
University of California,San Diego
University Medical Center Hamburg-Eppendorf
Tufts Medical Center Inc
Tufts University
Amsterdam University Medical Centre (Amsterdam UMC)
University of Exeter
Western Norway University of Applied Sciences

Research output: Contribution to journal › Article › peer-review

Abstract

To assess whether CC is more effective at reducing suicidal ideation in people with depression compared with usual care, and whether study and patient factors moderate treatment effects.

METHOD: We searched Medline, Embase, PubMed, PsycINFO, CINAHL, CENTRAL from inception to March 2020 for Randomised Controlled Trials (RCTs) that compared the effectiveness of CC with usual care in depressed adults, and reported changes in suicidal ideation at 4 to 6 months post-randomisation. Mixed-effects models accounted for clustering of participants within trials and heterogeneity across trials. This study is registered with PROSPERO, CRD42020201747.

RESULTS: We extracted data from 28 RCTs (11,165 patients) of 83 eligible studies. We observed a small significant clinical improvement of CC on suicidal ideation, compared with usual care (SMD, -0.11 [95%CI, -0.15 to -0.08]; I2, 0·47% [95%CI 0.04% to 4.90%]). CC interventions with a recognised psychological treatment were associated with small reductions in suicidal ideation (SMD, -0.15 [95%CI -0.19 to -0.11]). CC was more effective for reducing suicidal ideation among patients aged over 65 years (SMD, - 0.18 [95%CI -0.25 to -0.11]).

CONCLUSION: Primary care based CC with an embedded psychological intervention is the most effective CC framework for reducing suicidal ideation and older patients may benefit the most.

Original language	English
Pages (from-to)	27-35
Number of pages	9
Journal	General Hospital Psychiatry
Volume	71
Early online date	21 Apr 2021
DOIs	https://doi.org/10.1016/j.genhosppsych.2021.04.004
Publication status	E-pub ahead of print - 21 Apr 2021

Keywords

Collaborative care
suicidal ideation
Primary Care
Meta-analysis
Individual participant data analysis

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10.1016/j.genhosppsych.2021.04.004

https://doi.org/10.1016/j.genhosppsych.2021.04.004

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Grigoroglou, C., van der Feltz-Cornelis, C., Hodkinson, A., Coventry, P. A., Zghebi, S. S., Kontopantelis, E., Bower, P., Lovell, K., Gilbody, S., Waheed, W., Dickens, C., Archer, J., Blakemore, A., Adler, D. A., Aragones, E., Björkelund, C., Bruce, M. L., Buszewicz, M., Carney, R. M., ... Panagioti, M. (2021). Effectiveness of collaborative care in reducing suicidal ideation: An individual participant data meta-analysis. General Hospital Psychiatry, 71, 27-35. Advance online publication. https://doi.org/10.1016/j.genhosppsych.2021.04.004

@article{e8ac1babd3474793a48ec7086ea6adde,

title = "Effectiveness of collaborative care in reducing suicidal ideation: An individual participant data meta-analysis",

abstract = "To assess whether CC is more effective at reducing suicidal ideation in people with depression compared with usual care, and whether study and patient factors moderate treatment effects.METHOD: We searched Medline, Embase, PubMed, PsycINFO, CINAHL, CENTRAL from inception to March 2020 for Randomised Controlled Trials (RCTs) that compared the effectiveness of CC with usual care in depressed adults, and reported changes in suicidal ideation at 4 to 6 months post-randomisation. Mixed-effects models accounted for clustering of participants within trials and heterogeneity across trials. This study is registered with PROSPERO, CRD42020201747.RESULTS: We extracted data from 28 RCTs (11,165 patients) of 83 eligible studies. We observed a small significant clinical improvement of CC on suicidal ideation, compared with usual care (SMD, -0.11 [95\%CI, -0.15 to -0.08]; I2, 0·47\% [95\%CI 0.04\% to 4.90\%]). CC interventions with a recognised psychological treatment were associated with small reductions in suicidal ideation (SMD, -0.15 [95\%CI -0.19 to -0.11]). CC was more effective for reducing suicidal ideation among patients aged over 65 years (SMD, - 0.18 [95\%CI -0.25 to -0.11]).CONCLUSION: Primary care based CC with an embedded psychological intervention is the most effective CC framework for reducing suicidal ideation and older patients may benefit the most.",

keywords = "Collaborative care, suicidal ideation, Primary Care, Meta-analysis, Individual participant data analysis",

author = "Christos Grigoroglou and \{van der Feltz-Cornelis\}, Christina and Alexander Hodkinson and Coventry, \{Peter A\} and Zghebi, \{Salwa S\} and Evangelos Kontopantelis and Peter Bower and Karina Lovell and Simon Gilbody and Waquas Waheed and Christopher Dickens and Janine Archer and Amy Blakemore and Adler, \{David A\} and Enric Aragones and Cecilia Bj{\"o}rkelund and Bruce, \{Martha L\} and Marta Buszewicz and Carney, \{Robert M\} and Cole, \{Martin G\} and Davidson, \{Karina W\} and Jochen Gensichen and Grote, \{Nancy K\} and Joan Russo and Klaas Huijbregts and Huffman, \{Jeff C\} and Marco Menchetti and Vikram Patel and Richards, \{David A\} and Bruce Rollman and Annet Smit and Zijlstra-Vlasveld, \{Moniek C\} and Wells, \{Kenneth B\} and Thomas Zimmermann and Jurgen Unutzer and Maria Panagioti",

year = "2021",

month = apr,

day = "21",

doi = "10.1016/j.genhosppsych.2021.04.004",

language = "English",

volume = "71",

pages = "27--35",

journal = "General Hospital Psychiatry",

issn = "0163-8343",

publisher = "Elsevier BV",

}

Grigoroglou, C, van der Feltz-Cornelis, C, Hodkinson, A, Coventry, PA, Zghebi, SS , Kontopantelis, E , Bower, P , Lovell, K, Gilbody, S, Waheed, W, Dickens, C, Archer, J, Blakemore, A, Adler, DA, Aragones, E, Björkelund, C, Bruce, ML, Buszewicz, M, Carney, RM, Cole, MG, Davidson, KW, Gensichen, J, Grote, NK, Russo, J, Huijbregts, K, Huffman, JC, Menchetti, M, Patel, V, Richards, DA, Rollman, B, Smit, A, Zijlstra-Vlasveld, MC, Wells, KB, Zimmermann, T, Unutzer, J & Panagioti, M 2021, 'Effectiveness of collaborative care in reducing suicidal ideation: An individual participant data meta-analysis', General Hospital Psychiatry, vol. 71, pp. 27-35. https://doi.org/10.1016/j.genhosppsych.2021.04.004

TY - JOUR

T1 - Effectiveness of collaborative care in reducing suicidal ideation

T2 - An individual participant data meta-analysis

AU - Grigoroglou, Christos

AU - van der Feltz-Cornelis, Christina

AU - Hodkinson, Alexander

AU - Coventry, Peter A

AU - Zghebi, Salwa S

AU - Kontopantelis, Evangelos

AU - Bower, Peter

AU - Lovell, Karina

AU - Gilbody, Simon

AU - Waheed, Waquas

AU - Dickens, Christopher

AU - Archer, Janine

AU - Blakemore, Amy

AU - Adler, David A

AU - Aragones, Enric

AU - Björkelund, Cecilia

AU - Bruce, Martha L

AU - Buszewicz, Marta

AU - Carney, Robert M

AU - Cole, Martin G

AU - Davidson, Karina W

AU - Gensichen, Jochen

AU - Grote, Nancy K

AU - Russo, Joan

AU - Huijbregts, Klaas

AU - Huffman, Jeff C

AU - Menchetti, Marco

AU - Patel, Vikram

AU - Richards, David A

AU - Rollman, Bruce

AU - Smit, Annet

AU - Zijlstra-Vlasveld, Moniek C

AU - Wells, Kenneth B

AU - Zimmermann, Thomas

AU - Unutzer, Jurgen

AU - Panagioti, Maria

PY - 2021/4/21

Y1 - 2021/4/21

N2 - To assess whether CC is more effective at reducing suicidal ideation in people with depression compared with usual care, and whether study and patient factors moderate treatment effects.METHOD: We searched Medline, Embase, PubMed, PsycINFO, CINAHL, CENTRAL from inception to March 2020 for Randomised Controlled Trials (RCTs) that compared the effectiveness of CC with usual care in depressed adults, and reported changes in suicidal ideation at 4 to 6 months post-randomisation. Mixed-effects models accounted for clustering of participants within trials and heterogeneity across trials. This study is registered with PROSPERO, CRD42020201747.RESULTS: We extracted data from 28 RCTs (11,165 patients) of 83 eligible studies. We observed a small significant clinical improvement of CC on suicidal ideation, compared with usual care (SMD, -0.11 [95%CI, -0.15 to -0.08]; I2, 0·47% [95%CI 0.04% to 4.90%]). CC interventions with a recognised psychological treatment were associated with small reductions in suicidal ideation (SMD, -0.15 [95%CI -0.19 to -0.11]). CC was more effective for reducing suicidal ideation among patients aged over 65 years (SMD, - 0.18 [95%CI -0.25 to -0.11]).CONCLUSION: Primary care based CC with an embedded psychological intervention is the most effective CC framework for reducing suicidal ideation and older patients may benefit the most.

AB - To assess whether CC is more effective at reducing suicidal ideation in people with depression compared with usual care, and whether study and patient factors moderate treatment effects.METHOD: We searched Medline, Embase, PubMed, PsycINFO, CINAHL, CENTRAL from inception to March 2020 for Randomised Controlled Trials (RCTs) that compared the effectiveness of CC with usual care in depressed adults, and reported changes in suicidal ideation at 4 to 6 months post-randomisation. Mixed-effects models accounted for clustering of participants within trials and heterogeneity across trials. This study is registered with PROSPERO, CRD42020201747.RESULTS: We extracted data from 28 RCTs (11,165 patients) of 83 eligible studies. We observed a small significant clinical improvement of CC on suicidal ideation, compared with usual care (SMD, -0.11 [95%CI, -0.15 to -0.08]; I2, 0·47% [95%CI 0.04% to 4.90%]). CC interventions with a recognised psychological treatment were associated with small reductions in suicidal ideation (SMD, -0.15 [95%CI -0.19 to -0.11]). CC was more effective for reducing suicidal ideation among patients aged over 65 years (SMD, - 0.18 [95%CI -0.25 to -0.11]).CONCLUSION: Primary care based CC with an embedded psychological intervention is the most effective CC framework for reducing suicidal ideation and older patients may benefit the most.

KW - Collaborative care

KW - suicidal ideation

KW - Primary Care

KW - Meta-analysis

KW - Individual participant data analysis

U2 - 10.1016/j.genhosppsych.2021.04.004

DO - 10.1016/j.genhosppsych.2021.04.004

M3 - Article

C2 - 33915444

SN - 0163-8343

VL - 71

SP - 27

EP - 35

JO - General Hospital Psychiatry

JF - General Hospital Psychiatry

ER -

Effectiveness of collaborative care in reducing suicidal ideation: An individual participant data meta-analysis

Abstract

Keywords

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