Evidence map›Paper›PMID 29426288›Full record

Trial reportBMC family practice2018

Clinical effectiveness of care managers in collaborative care for patients with depression in Swedish primary health care: a pragmatic cluster randomized controlled trial.

Cecilia Björkelund, Irene Svenningsson, Dominique Hange, Camilla Udo, Eva-Lisa Petersson, Nashmil Ariai, Shabnam Nejati, Catrin Wessman, Carl Wikberg, Malin André and 2 more

Registry-linked trialOpen access · goldAbstract readMulticenter StudyPragmatic Clinical TrialRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC family practice, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02378272 (RCT on Care Manager Organization for Management of Mild-moderate Depression in the Primary Care Setting, Sweden), which is not on this map. Cited by 49 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
49citing papers in PubMed, 6 pooled it
13.1field-weighted citation impact, top 1% of its field
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.

NCT02378272 nacompletednot on this map

RCT on Care Manager Organization for Management of Mild-moderate Depression in the Primary Care Setting, Sweden

TypeinterventionalSponsorGöteborg UniversityRan2014 to 2018Enrolled376ConditionsDepressionArmscare manager for depression
3 · Its place in the literature

Who cites it

49 citing papers in PubMed, 6 syntheses or guidelines pooled it, 88 citations in OpenAlex.

  1. Integrated care models for youth mental health: A systematic review and meta-analysis.The Australian and New Zealand journal of psychiatry · 2024
    Pooled it
  2. Pooled it
  3. Pooled it
  4. Interventions to improve return to work in depressed people.The Cochrane database of systematic reviews · 2020
    Pooled it
  5. Pooled it
  6. Pooled it
  7. Trial
  8. Trial
  9. Trial
  10. Trial
  11. Trial
  12. Trial
  13. Trial
  14. Trial
  15. Trial
  16. Trial
  17. Trial
  18. Trial
  19. Article
  20. Article
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

12 authors at 5 institutions in 1 country.

Cecilia BjörkelundDepartment of Primary Health Care, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. Cecilia.bjorkelund@allmed.gu.se.ORCID 0000-0003-4083-7342
Irene SvenningssonDepartment of Primary Health Care, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Dominique HangeDepartment of Primary Health Care, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Camilla UdoSchool of Education, Health and Social Studies, Dalarna University, Falun, Sweden.
Eva-Lisa PeterssonDepartment of Primary Health Care, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Nashmil AriaiDepartment of Primary Health Care, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Shabnam NejatiDepartment of Primary Health Care, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Catrin WessmanHealth Metrics Unit, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Carl WikbergDepartment of Primary Health Care, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Malin AndréDepartment of Public Health and Caring Sciences - Family Medicine and Preventive Medicine, Uppsala University, Uppsala, Sweden.
Lars WallinSchool of Education, Health and Social Studies, Dalarna University, Falun, Sweden.
Jeanette WestmanDivision of Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden.
University of Gothenburg · SEDalarna University · SEKarolinska Institutet · SERegion Västra Götaland · SEUppsala University · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDepression is one of the leading causes of disability and affects 10-15% of the population. The majority of people with depressive symptoms seek care and are treated in primary care. Evidence internationally for high quality care supports collaborative care with a care manager. Our aim was to study clinical effectiveness of a care manager intervention in management of primary care patients with depression in Sweden.

methodsIn a pragmatic cluster randomized controlled trial 23 primary care centers (PCCs), urban and rural, included patients aged ≥ 18 years with a new (< 1 month) depression diagnosis. Intervention consisted of Care management including continuous contact between care manager and patient, a structured management plan, and behavioral activation, altogether around 6-7 contacts over 12 weeks. Control condition was care as usual (CAU). OUTCOME MEASURES: Depression symptoms (measured by Mongomery-Asberg depression score-self (MADRS-S) and BDI-II), quality of life (QoL) (EQ-5D), return to work and sick leave, service satisfaction, and antidepressant medication. Data were analyzed with the intention-to-treat principle.

resultsOne hundred ninety two patients with depression at PCCs with care managers were allocated to the intervention group, and 184 patients at control PCCs were allocated to the control group. Mean depression score measured by MADRS-S was 2.17 lower in the intervention vs. the control group (95% CI [0.56; 3.79], p = 0.009) at 3 months and 2.27 lower (95% CI [0.59; 3.95], p = 0.008) at 6 months; corresponding BDI-II scores were 1.96 lower (95% CI [- 0.19; 4.11], p = 0.07) in the intervention vs. control group at 6 months. Remission was significantly higher in the intervention group at 6 months (61% vs. 47%, p = 0.006). QoL showed a steeper increase in the intervention group at 3 months (p = 0.01). During the first 3 months, return to work was significantly higher in the intervention vs. the control group. Patients in the intervention group were more consistently on antidepressant medication than patients in the control group.

conclusionsCare managers for depression treatment have positive effects on depression course, return to work, remission frequency, antidepressant frequency, and quality of life compared to usual care and is valued by the patients.

trial registrationIdentifier: NCT02378272 . February 2, 2015. Retrospectively registered.

Indexed as

Case ManagementPatient SatisfactionPrimary Health CareAdultAntidepressive AgentsDepressionDepressive DisorderFemaleHumansMaleMiddle AgedPatient Care ManagementPatient Reported Outcome MeasuresRemission InductionSurveys and QuestionnairesSwedenAntidepressive AgentsCare managerCollaborative careDepressionPrimary careQuality-of- lifeSick-leave

Identifiers

PMID29426288
PMCPMC5807835
OpenAlexW2788731488

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

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.