Evidence map›Paper›PMID 26150142›Full record

SynthesisBMJ open2015

A systematic review of the predictors of health service utilisation by adults with mental disorders in the UK.

Conal D Twomey, David S Baldwin, Maren Hopfe, Alarcos Cieza

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ open, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
47citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

47 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Conal D TwomeyFaculty of Social and Human Sciences, University of Southampton, Southampton, UK.
David S BaldwinFaculty of Medicine, University of Southampton, Southampton, UK.
Maren HopfeSwiss Paraplegic Research, Nottwil, Switzerland Department of Health Sciences & Health Policy, University of Lucerne, Lucerne, Switzerland.
Alarcos CiezaFaculty of Social and Human Sciences, School of Psychology, University of Southampton, UK Department of Medical Informatics, Biometry and Epidemiology-IBE, Research Unit for Biopsychosocial Health, Ludwig-Maximilians-University (LMU), Munich, Germany Swiss Paraplegic Research, Nottwil, Switzerland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo identify variables that predict health service utilisation (HSU) by adults with mental disorders in the UK, and to determine the evidence level for these predictors.

designA narrative synthesis of peer-reviewed studies published after the year 2000. The search was conducted using four databases (ie, PsycINFO, CINAHL Plus with full text, MEDLINE and EMBASE) and completed on 25 March 2014.

settingThe majority of included studies were set in health services across primary, secondary, specialist and inpatient care. Some studies used data from household and postal surveys.

participantsIncluded were UK-based studies that predicted HSU by adults with mental disorders. Participants had a range of mental disorders including psychotic disorders, personality disorders, depression, anxiety disorders, eating disorders and dementia. PRIMARY OUTCOME: A wide range of HSU outcomes were examined, including general practitioner (GP) contacts, medication usage, psychiatrist contacts, psychotherapy attendances, inpatient days, accident and emergency admissions and 'total HSU'.

resultsTaking into account study quality, 28 studies identified a range of variables with good preliminary evidence supporting their ability to predict HSU. Of these variables, comorbidity, personality disorder, age (heterogeneous age ranges), neurotic symptoms, female gender, a marital status of divorced, separated or widowed, non-white ethnicity, high previous HSU and activities of daily living, were associated with increased HSU. Moreover, good preliminary evidence was found for associations of accessing a primary care psychological treatment service and medication use with decreased HSU.

conclusionsThe findings can inform decisions about which variables might be used to derive mental health clusters in 'payment by results' systems in the UK. The findings also support the need to investigate whether combining broad diagnoses with care pathways is an effective method for mental health clustering, and the need for research to further examine the association between mental health clusters and HSU.

Indexed as

Activities of Daily LivingAge FactorsAnxiety DisordersComorbidityDementiaDepressive DisorderFeeding and Eating DisordersFemaleHealth ServicesHospitalizationHumansMaleMarital StatusMental DisordersMental Health ServicesPersonality DisordersHEALTH ECONOMICSHEALTH SERVICES ADMINISTRATION & MANAGEMENTMENTAL HEALTH

Identifiers

PMID26150142
PMCPMC4499684

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.