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A randomised controlled trial and cost analysis of problem-solving treatment for emotional disorders given by community nurses in primary care

Published online by Cambridge University Press:  03 January 2018

Laurence Mynors-Wallis ,
Ioana Davies ,
Alastair Gray ,
Faith Barbour  and
Dennis Gath
Laurence Mynors-Wallis*
Affiliation:
Oxford University Press, University Department of Psychiatry, Oxford
Ioana Davies
Affiliation:
Oxford University Press, University Department of Psychiatry, Oxford
Alastair Gray
Affiliation:
Oxford University Press, University Department of Psychiatry, Oxford
Faith Barbour
Affiliation:
Oxford University Press, University Department of Psychiatry, Oxford
Dennis Gath
Affiliation:
Oxford University Press, University Department of Psychiatry, Oxford
*
Dr L. Mynors-Wallis, Oxford University Department of Psychiatry, Warneford Hospital, Oxford OX3 7JX
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Abstract

Background

We set out to investigate whether community nurses could be trained in problem-solving therapy and, once trained, how effective they would be in treating emotional disorders in primary care.

Method

Seventy patients with an emotional disorder in primary care were randomly allocated to receive either problem-solving therapy from a trained community nurse or treatment as usual from their general practitioner. Interview and self-rated assessments of clinical and economic outcome were made pre-treatment, at eight weeks and at 26 weeks after treatment.

Results

There was no difference in clinical outcome between patients who received problem-solving treatment and patients who received the general practitioner's usual treatment. However, patients who received problem-solving treatment had fewer disability days and fewer days off work. The health care cost of problem-solving was greater than that of the general practitioner's usual treatment but this was more than offset by savings in the cost of days off work.

Conclusions

Problem-solving treatment can be given by trained community nurses. The clinical effectiveness and cost-benefit of the treatment will depend on the selection of appropriate patients.

Type
Papers
Information
The British Journal of Psychiatry , Volume 170 , Issue 2 , February 1997 , pp. 113 - 119
Copyright
Copyright © 1997 The Royal College of Psychiatrists 

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