Article: Brief problem-solving treatment in primary care (PST-PC) was not more effective than placebo for elderly patients screened positive of psychological problems

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TitleBrief problem-solving treatment in primary care (PST-PC) was not more effective than placebo for elderly patients screened positive of psychological problems
AuthorsLam, CLK1
Fong, DYT1
Chin, WY1
Lee, PWH1
Lam, ETP1
Lo, YYC1
KeywordsChinese
elderly
mental illness
primary care
problem solving treatment
screening
Issue Date2010
PublisherJohn Wiley & Sons Ltd. The Journal's web site is located at http://www3.interscience.wiley.com/cgi-bin/jhome/4294
CitationInternational Journal Of Geriatric Psychiatry, 2010, v. 25 n. 10, p. 968-980 [How to Cite?]
DOI: http://dx.doi.org/10.1002/gps.2435
AbstractObjectives To evaluate whether screening followed by brief problem-solving treatment by primary care doctors (PST-PC) could improve health-related quality of life (HRQOL) and reduce consultation rates in the elderly. Design A single-blind randomized placebo controlled trial (RCT). Setting Two government funded primary care clinics in Hong Kong. Participants Two hundred and ninety nine Chinese patients aged 60 years or over, with positive screening scores for psychological problems by the Hospital Anxiety and Depression Scale (HADS). Interventions One hundred and forty nine subjects were randomized to receive brief PST-PC from primary care doctors (treatment) and 150 to group video-viewing (placebo). All subjects were followed up by telephone at 6, 12, 26 and 52 weeks. Main Outcome Measures Changes in SF-36 HRQOL scores, HADS scores and monthly consultation rates were compared within and between groups. Results Study completion rates were 69-71%. There was significant improvement in the SF-36 role-emotional (RE) and mental component summary (MCS) scores at week 6 in the PST-PC group but not in the placebo group. Several SF-36 scores improved significantly in the placebo (video) group at week 6-52. Mixed effects analysis adjusting for baseline values and cofounders did not show any difference in any of the outcomes between the PST-PC and placebo (video) groups. Conclusions Screening followed by brief PST-PC was associated with a short-term improvement in HRQOL in Chinese elderly patients screened positive of psychological problems, but the HRQOL benefit was not greater than those found in the placebo group who participated in group-viewings of health education videos. © 2009 John Wiley & Sons, Ltd.
ISSN0885-6230
2011 Impact Factor: 2.419
2011 SCImago Journal Rankings: 0.120
DOIhttp://dx.doi.org/10.1002/gps.2435
ReferencesReferences in Scopus
GrantsA randomised controlled trial on the effectiveness of screening and brief problem-solving counselling for elderly patients with undiagnosed psychological problems in primary care
DC Field
Value
dc.contributor.authorLam, CLK
dc.contributor.authorFong, DYT
dc.contributor.authorChin, WY
dc.contributor.authorLee, PWH
dc.contributor.authorLam, ETP
dc.contributor.authorLo, YYC
dc.date.accessioned2010-10-31T11:10:02Z
dc.date.available2010-10-31T11:10:02Z
dc.date.issued2010
dc.description.abstractObjectives To evaluate whether screening followed by brief problem-solving treatment by primary care doctors (PST-PC) could improve health-related quality of life (HRQOL) and reduce consultation rates in the elderly. Design A single-blind randomized placebo controlled trial (RCT). Setting Two government funded primary care clinics in Hong Kong. Participants Two hundred and ninety nine Chinese patients aged 60 years or over, with positive screening scores for psychological problems by the Hospital Anxiety and Depression Scale (HADS). Interventions One hundred and forty nine subjects were randomized to receive brief PST-PC from primary care doctors (treatment) and 150 to group video-viewing (placebo). All subjects were followed up by telephone at 6, 12, 26 and 52 weeks. Main Outcome Measures Changes in SF-36 HRQOL scores, HADS scores and monthly consultation rates were compared within and between groups. Results Study completion rates were 69-71%. There was significant improvement in the SF-36 role-emotional (RE) and mental component summary (MCS) scores at week 6 in the PST-PC group but not in the placebo group. Several SF-36 scores improved significantly in the placebo (video) group at week 6-52. Mixed effects analysis adjusting for baseline values and cofounders did not show any difference in any of the outcomes between the PST-PC and placebo (video) groups. Conclusions Screening followed by brief PST-PC was associated with a short-term improvement in HRQOL in Chinese elderly patients screened positive of psychological problems, but the HRQOL benefit was not greater than those found in the placebo group who participated in group-viewings of health education videos. © 2009 John Wiley & Sons, Ltd.
dc.description.grantA randomised controlled trial on the effectiveness of screening and brief problem-solving counselling for elderly patients with undiagnosed psychological problems in primary care
dc.description.grantcode8310
dc.description.naturepostprint
dc.identifier.citationInternational Journal Of Geriatric Psychiatry, 2010, v. 25 n. 10, p. 968-980 [How to Cite?]
DOI: http://dx.doi.org/10.1002/gps.2435
dc.identifier.doihttp://dx.doi.org/10.1002/gps.2435
dc.identifier.epage980
dc.identifier.hkuros175978
dc.identifier.isiWOS:000283341700005
Funding AgencyGrant Number
Food and Health Bureau, the Government of the Hong Kong SAR218016
Funding Information:

The authors would like to thank Dr Stephen W. K. Chow, Dr Kevin K. L. Pang, Dr Johnny C.Y. Lam, Dr Sam C. S. Au, Dr Jacky H. H. Sze and Dr Brigitte E. Schlaikier for providing the PST-PC. The authors would also like to acknowledge On-On Cheng and Alice O.L. Cheung for their assistance in data collection and analysis. This project was supported by the Health Care and Promotion Fund (project ref no # 218016) of the Food and Health Bureau, the Government of the Hong Kong SAR.

dc.identifier.issn0885-6230
2011 Impact Factor: 2.419
2011 SCImago Journal Rankings: 0.120
dc.identifier.issue10
dc.identifier.openurl
dc.identifier.pmid20033901
dc.identifier.scopuseid_2-s2.0-78649421216
dc.identifier.spage968
dc.identifier.urihttp://hdl.handle.net/10722/125076
dc.identifier.volume25
dc.languageeng
dc.publisherJohn Wiley & Sons Ltd. The Journal's web site is located at http://www3.interscience.wiley.com/cgi-bin/jhome/4294
dc.publisher.placeUnited Kingdom
dc.relation.ispartofInternational Journal of Geriatric Psychiatry
dc.relation.referencesReferences in Scopus
dc.rightsInternational Journal of Geriatric Psychiatry. Copyright © John Wiley & Sons Ltd.
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License
dc.rightsThis is a preprint of an article published in International Journal of Geriatric Psychiatry, 2010, v. 25 n. 10, p. 968-980
dc.subject.meshHealth Education - methods
dc.subject.meshMental Disorders - therapy
dc.subject.meshPrimary Health Care
dc.subject.meshProblem Solving
dc.subject.meshPsychotherapy, Brief - methods - standards
dc.subjectChinese
dc.subjectelderly
dc.subjectmental illness
dc.subjectprimary care
dc.subjectproblem solving treatment
dc.subjectscreening
dc.titleBrief problem-solving treatment in primary care (PST-PC) was not more effective than placebo for elderly patients screened positive of psychological problems
dc.typeArticle
Author Affiliations
  1. The University of Hong Kong