Table 1 Characteristics of randomized controlled trials comparing collaborative care for anxiety disorders with care as usual
From: Collaborative care for anxiety disorders in primary care: a systematic review and meta-analysis
Study No. | Authors/ year | De-sign | Recruit-ment | Diagn instr. | Int. | Setting | N(ITT) | Collaborative care intervention | Professionals involved | Comparison intervention | Outcomes FU | Outcome CC vs CAU | Outcome at 12 months [95 % CI] |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1 | Roy-Byrne et al. 2001 (Study 1) | RCT | Referral Screening (waiting room, PHQ-2 PD) | PD CIDI | CC vs CAU | 3 primary care clinics (US) | CC: 57 CAU: 58 | Medication management by psychiatrist | PCP, psychiatrist | CAU by PCP, i.e. pharmacotherapy or referral to mental health professional | ASI, PDSS 3,6,9,12 months | -Improved anxiety outcome at 3,6 and 12 months -Improved panic outcome at 6 months | -Anxiety/panic (ASI): T = 2.14, p = 0.035 ES 0.45 [0.03-0.87] -Panic (PDSS): statistics continuous outcome not reported |
2 | Roy-Byrne et al. 2005 (Study 2) | RCT | Referral Screening (waiting room, PHQ-2 PD) | PD CIDI | CC vs CAU | University affiliated primary care clinics (US) | CC: 119 CAU: 113 | CBT and/or antidepressant medication | PCP, CM, psychiatrist | CAU by PCP, i.e. pharmacotherapy or referral to mental health professional | ASI 3,6,9,12 months | -Improved anxiety/panic outcome at all time points | - Anxiety/panic (ASI): Dif −6.64 [−10.73 to −2.48] p <0.001; ES 0.48 [0.18-0.78] |
3 | Rollman et al. 2005 (Study 3) | RCT | Screening (waiting room, PHQ) | PD/ GAD PRIME-MD | CC vs CAU | 4 university affiliated primary care practices (US) | CC: 116 CC: 75 | Guided selfhelp and/or antidepressant medication and/or referral to mental health specialist | PCP, CM, psychiatrist/ Psycho-therapist | CAU by PCP and patients received a diagnosis specific brochure | SIGH-A, PDSS 2,4,8,12 months | -Improved anxiety outcome at 12 months - Improved panic outcomes at 12 months -No sign. improvement in GAD outcomes | -Anxiety (SIGH-A): Dif −3.6 [ −6.4 to −0.8] p = 0.01; ES 0.43 [0.10-0.77] -Panic (PDSS): Diff −3.3 [−5.5 to −1.1] p = 0.004; ES 0.58 [0.19-0.97] -GAD (SIGH-A): Diff −1.1 [−5.0 to 2.7] p = 0.57; ES 0.13 [−0.32 to 0.58] |
4 | Konig et al. 2009 (Study 4) | Clus-ter RCT | Screening (PHQ) | PD/ GAD/ any AD PHQ | CC vs CAU | 46 primary care practices (GER) | CC: 201 CAU: 188 | Counselling (CBT) by the PCP | PCP, psychiatrist/ Psycho-therapist | CAU by PCP, including referral to mental health professional | BAI 6,9 months | - No difference in anxiety outcomes | -Anxiety (BAI): CC: M 18.18 SD 12.17 CAU: M 16.72 SD 10.34, p = 0.35; ES −0.13 [−0.36-0.10] |
5 | Roy-Byrne et al. 2010 (Study 5) | RCT | Referral | PD/ GAD/ SOP/ PTSD MINI | CC vs CAU | 17 primary care clinics (US) | CC: 503 CAU: 501 | CBT and/or antidepressant medication | PCP, CM, psychiatrist | CAU by PCP, i.e. medication, counseling or referral to mental health professional | BSI, PDSS, GADSS, SPIN, PCL 6,12,18 months | -Improved anxiety outcome at all time points -Improved panic outcome at 6 and 12 months -Improved GAD outcome at all time points -Improved SOP outcome at 6 and 12 months -No sign. improvement in PTSD outcomes | -Anxiety (BSI): Diff −2.63 [ −3.73 to −1.54] p <0.001; ES 0.33 [0.19-0.47] -Panic (PDSS): Diff −2.71 [ −4.29 to −1.14] p = .003; ES 0.48 [0.20-0.76] -GAD (GADSS): Diff −2.34 [−3.22 to −1.45] p <0.001; ES 0.49 [0.30 to 0.68] -SOP (SPIN): Diff −5.71 [−10.74 to −0.68] p = 0.08; ES 0.43 [0.05 to 0.81] - PTSD (PCL-C): Diff −7.7 [−17.55 to 2.15] p = 0.49; ES 0.45 [−0.12 to 1.02] |
6 | Oosterbaan et al. 2013 (Study 6) | Clus-ter RCT | Referral | PD/AGO/GAD/SOP/SP MINI | CC vs CAU | 22 primary care practices (NL) | CC: 28 CAU: 27 | Step 1) CBT based guided self-help with antidepressant medication for moderate disorder Step 2) CBT and medication in specialty care | PCP, CM, psychiatrist, CBT therapist | CAU by PCP, i.e. medication, counseling or referral to mental health professional | CGI-I, CGI-S, HRS-A 4,8,12 months | -Improved anxiety outcomes at 4 months | -Anxiety (HRS-A) CC: M 6.14 SD 5.26 CAU M: 8.11 SD 7.83 p = 0.02 ES 0.29 [−0.29 to 0.87] |
7 | Muntingh et al. 2014 (Study 7) | Clus-ter RCT | Referral Screening (PHQ) | PD/ GAD MINI | CC vs CAU | 43 primary care practices (NL) | CC: 114 CAU: 66 | Step 1) CBT based guided self-help Step 2) CBT Step 3) antidepressant medication | PCP, CM, psychiatrist, CBT therapist | CAU by PCP, i.e. medication, counseling or referral to mental health professional (including CM randomized to CAU) | BAI | -Improved anxiety outcome at all time points -Improved panic outcome at all time points -No sign. improvement in GAD outcomes | -Anxiety (BAI) Diff −6.84 [ −10.13 to −3.55] p <0.001; ES 0.73 [0.37-1.09] - PD (BAI): Diff −9.29 [−12.99 to −5.59] ES 1.03 [0.60 to 1.46] - GAD (BAI): Diff −1.13 [−7.33 to 5.08] p = 0.72 ES 0.13 [−0.56 – 0.81] |