Use of a personalised depression intervention in primary care to prevent anxiety: a secondary study of a cluster randomised trial
Metadatos
Mostrar el registro completo del ítemEditorial
Royal Coll General Practitioners
Materia
Anxiety Controlled clinical trial Depressions Primary care Primary prevention
Fecha
2021-02Referencia bibliográfica
Moreno-Peral, P., Conejo-Cerón, S., de Dios Luna, J., King, M., Nazareth, I., Martín-Pérez, C., ... & Bellón, J. Á. (2021). Use of a personalised depression intervention in primary care to prevent anxiety: a secondary study of a cluster randomised trial. British Journal of General Practice, 71(703), e95-e104.[DOI: https://doi.org/10.3399/bjgp20X714041]
Resumen
Background
In the predictD-intervention, GPs used a
personalised biopsychosocial programme to
prevent depression. This reduced the incidence of
major depression by 21.0%, although the results
were not statistically significant.
Aim
To determine whether the predictD-intervention
is effective at preventing anxiety in primary care
patients without depression or anxiety.
Design and setting
Secondary study of a cluster randomised trial
with practices randomly assigned to either the
predictD-intervention or usual care. This study
was conducted in seven Spanish cities from
October 2010 to July 2012.
Method
In each city, 10 practices and two GPs per
practice, as well as four to six patients every
recruiting day, were randomly selected until there
were 26–27 eligible patients for each GP. The
endpoint was cumulative incidence of anxiety as
measured by the PRIME-MD screening tool over
18 months.
Results
A total of 3326 patients without depression and
140 GPs from 70 practices consented and were
eligible to participate; 328 of these patients were
removed because they had an anxiety syndrome
at baseline. Of the 2998 valid patients, 2597
(86.6%) were evaluated at the end of the study.
At 18 months, 10.4% (95% CI = 8.7% to 12.1%) of
the patients in the predictD-intervention group
developed anxiety compared with 13.1% (95%
CI = 11.4% to 14.8%) in the usual-care group
(absolute difference = –2.7% [95% CI = –5.1% to
–0.3%]; P = 0.029).
Conclusion
A personalised intervention delivered by GPs for
the prevention of depression provided a modest
but statistically significant reduction in the
incidence of anxiety.