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Related Experiment Videos

Counselling for depression in primary care.

N Rowland1, P Bower, C Mellor

  • 1York Health Services Research Unit, York NHS Trust, Bootham Park Hospital, Bootham, York, North Yorkshire, UK, Y030 7BY. Nancy.Rowland@excha.yhs-tr.northy.nhs.uk

The Cochrane Database of Systematic Reviews
|May 2, 2001
PubMed
Summary

Counselling in primary care significantly improves psychological symptoms and patient satisfaction. However, evidence on cost-effectiveness remains limited, with no clear advantage over usual general practice care.

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Area of Science:

  • Psychology
  • Primary Care Medicine
  • Health Economics

Background:

  • Growing support exists for counselling within primary care settings, particularly in the UK.
  • This review focuses on the effectiveness and cost-effectiveness of counselling for psychological and psychosocial issues in primary care.

Purpose of the Study:

  • To evaluate the impact of primary care counselling on patient outcomes.
  • To review cost and outcome data for patients receiving counselling for psychological and psychosocial problems.

Main Methods:

  • Systematic review of randomized and controlled patient preference trials comparing counselling with usual general practitioner care.
  • Searched multiple databases and unpublished sources, including clinical trials and expert consultations.
  • Independent assessment of trial appropriateness and methodological quality by at least two reviewers.

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Main Results:

  • Four trials involving 678 participants were included; 487 were followed up.
  • Counselling significantly improved psychological symptom levels compared to usual care (SMD -0.30, 95% CI: -0.49 to -0.11).
  • Patients receiving counselling reported higher satisfaction, but no clear cost advantage was found.

Conclusions:

  • Primary care counselling leads to better psychological symptom levels and high patient satisfaction.
  • Limited data exists on cost-effectiveness, with one study showing no significant difference compared to general practice care.
  • The reviewed trials were pragmatic, reflecting real-world UK primary care; methodological limitations were noted.