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Table 3 Study Results

From: Does GP training in depression care affect patient outcome? - A systematic review and meta-analysis

Study Follow Up Attrition Rate %a Outcome Results Limitations Effect Sizeb
Baker (2001) [36] 16 weeks 6 Proportion of patients w/BDI < 11 Sign. diff in proportion of patients w/BDI > 11 (OR = 2.5) Tailored intervention that makes GP comparison impossible since they all received diff kinds of intervention /
Bosmans (2006) [33] 12 mo 21 PRIME-MD No sign. diff in MD recovery Possible Hawthorne effect, less severe episodes of MD in primary care, no blinding of patients -0.07
Gask (2004) [38] 3, 12 mo 37 HAM-D No sign. diff in scores at both follow up points Use of a new-onset (depressed less than 6 mo) sample
Attrition rate rather high
Kendrick (2001) [34] 12 mo 19 Hospital Admittance No sign. difference Implemented guidelines had been tested in highly selected samples
Dimensional diagnosis
Potential conservative bias (chronic depressed patients)
Thompson (2000) [35] 6 weeks/6 mo 50 HAD No diff in improvement, no diff in caseness rating at both points
Only patients recognized as cases at baseline improve sign. during first 6 weeks (p = 0.044), no diff at 6 mo
See Kendrick (2001) /
    Diagnosis sensitivity No diff in sensitivity nor specificity See Kendrick (2001) /
King (2002) [41] 6 mo 10 BDI No sign. diff in BDI scores (p = 0.84) Smaller sample than anticipated
Cut off score for inclusion rather high (makes intervention effect of CBT by lay GPs less likely)
Llewellyn-Jones (1999)
9.5 mo 23 GDS Sign. change in GDS scores Serial mono-centered design
Control group assessment before implementation of intervention
Rost (2001) [44] 6 mo 10 mCES-D Sign. reduction in score in patients beginning new treatment episode GP training effect unclear, feedback of diagnosis could be responsible for treatment effect
Homogenous sample
Pyne (2003) [43] 12 mo 65 Depression severity Sign. decrease (7.7 units) in experimental group See Rost (2001) /
Rost (2005) [45] 24 mo 70 Depression Free Days Sign. more depression free days in experimental group (647.6 vs. 558.2) See Rost (2001) /
Worrall (1999) [39] 6 mo ? Gain score CES-D Sign. improvement in experimental group Possible Hawthorne effect -0.22
  1. a all groups, last follow up;b calculated as the mean difference of experimental and control group at the latest post-treatment measurement;c adopted from Bower et al. (2006) [45].
  2. Abbreviations: BDI - Beck's Depression Inventory; CBT - Cognitive Behavioral Therapy; CE Ratio - Cost Effectiveness Ratio; mCES-D - (modified) Center for Epidemiologic Studies Depression Scale; CIDI - Composite International Diagnostic Interview; diff - difference; GDS - Geriatric Depression Scale; GP - General Practitioner; HAD - Hospital Anxiety and Depression Scale; HAM-D Hamilton Depression Scale; mo - month(s); MD - Major Depression; PRIME-MD - Primary care Evaluation of Mental Disorders; QALY - Quality of Adjusted Life Year; SF12 - Short Form 12-Item Health Survey; sign - significant