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Brief problem‐solving treatment in primary care (pst‐pc) was not more effective than placebo for elderly patients screened positive of psychological problems
Author(s) -
Lam Cindy L. K.,
Fong Daniel Y. T.,
Chin WengYee,
Lee Peter W. H.,
Lam Elegance T. P.,
Lo Yvonne Y. C.
Publication year - 2010
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.2435
Subject(s) - placebo , medicine , quality of life (healthcare) , psychological intervention , randomized controlled trial , anxiety , physical therapy , depression (economics) , placebo controlled study , hospital anxiety and depression scale , psychiatry , double blind , alternative medicine , nursing , pathology , macroeconomics , economics
Objectives To evaluate whether screening followed by brief problem‐solving treatment by primary care doctors (PST‐PC) could improve health‐related quality of life (HRQOL) and reduce consultation rates in the elderly. Design A single‐blind randomized placebo controlled trial (RCT). Setting Two government funded primary care clinics in Hong Kong. Participants Two hundred and ninety nine Chinese patients aged 60 years or over, with positive screening scores for psychological problems by the Hospital Anxiety and Depression Scale (HADS). Interventions One hundred and forty nine subjects were randomized to receive brief PST‐PC from primary care doctors (treatment) and 150 to group video‐viewing (placebo). All subjects were followed up by telephone at 6, 12, 26 and 52 weeks. Main Outcome Measures Changes in SF‐36 HRQOL scores, HADS scores and monthly consultation rates were compared within and between groups. Results Study completion rates were 69–71%. There was significant improvement in the SF‐36 role‐emotional (RE) and mental component summary (MCS) scores at week 6 in the PST‐PC group but not in the placebo group. Several SF‐36 scores improved significantly in the placebo (video) group at week 6–52. Mixed effects analysis adjusting for baseline values and cofounders did not show any difference in any of the outcomes between the PST‐PC and placebo (video) groups. Conclusions Screening followed by brief PST‐PC was associated with a short‐term improvement in HRQOL in Chinese elderly patients screened positive of psychological problems, but the HRQOL benefit was not greater than those found in the placebo group who participated in group‐viewings of health education videos. Copyright © 2009 John Wiley & Sons, Ltd.