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The effectiveness of enhanced evidence-based care for depressive disorders: a meta-analysis of randomized controlled trials
Xiao, Le1; Qi, Han1; Zheng, Wei2; Xiang, Yu Tao3,4,5; Carmody, Thomas J.6; Mayes, Taryn L.7; Trivedi, Madhukar H.7; Wang, Gang1
2021-12-01
Source PublicationTranslational Psychiatry
ISSN2158-3188
Volume11Issue:1
Abstract

Several care models have been developed to improve treatment for depression, all of which provide “enhanced” evidence-based care (EEC). The essential component of these approaches is Measurement-Based Care (MBC). Specifically, Collaborative Care (CC), and Algorithm-guided Treatment (AGT), and Integrated Care (IC) all use varying forms of rigorous MBC assessment, care management, and/or treatment algorithms as key instruments to optimize treatment delivery and outcomes for depression. This meta-analysis systematically examined the effectiveness of EEC versus usual care for depressive disorders based on cluster-randomized studies or randomized controlled trials (RCTs). PubMed, the Cochrane Library, and PsycInfo, EMBASE, up to January 6th, 2020 were searched for this meta-analysis. The electronic search was supplemented by a manual search. Standardized mean difference (SMD), risk ratio (RR), and their 95% confidence intervals (CIs) were calculated and analyzed. A total of 29 studies with 15,255 participants were analyzed. EEC showed better effectiveness with the pooled RR for response of 1.30 (95%CI: 1.13–1.50, I = 81.9%, P < 0.001, 18 studies), remission of 1.35 (95%CI: 1.11–1.64, I = 85.5%, P < 0.001, 18 studies) and symptom reduction with a pooled SMD of −0.42 (95%CI: −0.61–(−0.23), I = 94.3%, P < 0.001, 19 studies). All-cause discontinuations were similar between EEC and usual care with the pooled RR of 1.08 (95%CI: 0.94–1.23, I = 68.0%, P = 0.303, 27 studies). This meta-analysis supported EEC as an evidence-based framework to improve the treatment outcome of depressive disorders. Review registration: PROSPERO: CRD42020163668

DOI10.1038/s41398-021-01638-7
URLView the original
Indexed BySCIE ; SSCI
Language英語English
WOS Research AreaPsychiatry
WOS SubjectPsychiatry
WOS IDWOS:000707708000003
Scopus ID2-s2.0-85117449474
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Cited Times [WOS]:0   [WOS Record]     [Related Records in WOS]
Document TypeJournal article
CollectionUniversity of Macau
Corresponding AuthorXiang, Yu Tao; Wang, Gang
Affiliation1.The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
2.Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
3.Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao
4.Center for Cognition and Brain Sciences, University of Macau, Macao
5.Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao
6.Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, United States
7.Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, United States
Corresponding Author AffilicationFaculty of Health Sciences;  University of Macau
Recommended Citation
GB/T 7714
Xiao, Le,Qi, Han,Zheng, Wei,et al. The effectiveness of enhanced evidence-based care for depressive disorders: a meta-analysis of randomized controlled trials[J]. Translational Psychiatry,2021,11(1).
APA Xiao, Le,Qi, Han,Zheng, Wei,Xiang, Yu Tao,Carmody, Thomas J.,Mayes, Taryn L.,Trivedi, Madhukar H.,&Wang, Gang.(2021).The effectiveness of enhanced evidence-based care for depressive disorders: a meta-analysis of randomized controlled trials.Translational Psychiatry,11(1).
MLA Xiao, Le,et al."The effectiveness of enhanced evidence-based care for depressive disorders: a meta-analysis of randomized controlled trials".Translational Psychiatry 11.1(2021).
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