TY - JOUR
KW - Adult
KW - Anxiety Disorders/nursing/therapy
KW - Cluster Analysis
KW - Cognitive Therapy
KW - Cooperative Behavior
KW - Evidence-Based Medicine/methods
KW - Female
KW - Follow-Up Studies
KW - Humans
KW - Intention to Treat Analysis
KW - Interprofessional Relations
KW - Male
KW - Middle Aged
KW - Multilevel Analysis
KW - Netherlands
KW - Outcome Assessment (Health Care)/statistics & numerical data
KW - Patient Care Management/methods/organization & administration
KW - Patient Care Team
KW - Primary Health Care/methods
KW - Psychiatric Nursing
KW - Psychiatric Status Rating Scales
KW - Self Care/methods
AU - A. Muntingh
AU - C. van der Feltz-Cornelis
AU - H. van Marwijk
AU - P. Spinhoven
AU - W. Assendelft
AU - M. de Waal
AU - H. Ader
AU - A. van Balkom
A1 - 
AB - BACKGROUND: Collaborative stepped care (CSC) may be an appropriate model to provide evidence-based treatment for anxiety disorders in primary care. METHODS: In a cluster randomised controlled trial, the effectiveness of CSC compared to care as usual (CAU) for adults with panic disorder (PD) or generalised anxiety disorder (GAD) in primary care was evaluated. Thirty-one psychiatric nurses who provided their services to 43 primary care practices in the Netherlands were randomised to deliver CSC (16 psychiatric nurses, 23 practices) or CAU (15 psychiatric nurses, 20 practices). CSC was provided by the psychiatric nurses (care managers) in collaboration with the general practitioner and a consultant psychiatrist. The intervention consisted of 3 steps, namely guided self-help, cognitive behavioural therapy and antidepressants. Anxiety symptoms were measured with the Beck Anxiety Inventory (BAI) at baseline and after 3, 6, 9 and 12 months. RESULTS: We recruited 180 patients with a DSM-IV diagnosis of PD or GAD, of whom 114 received CSC and 66 received usual primary care. On the BAI, CSC was superior to CAU [difference in gain scores from baseline to 3 months: -5.11, 95% confidence interval (CI) -8.28 to -1.94; 6 months: -4.65, 95% CI -7.93 to -1.38; 9 months: -5.67, 95% CI -8.97 to -2.36; 12 months: -6.84, 95% CI -10.13 to -3.55]. CONCLUSIONS: CSC, with guided self-help as a first step, was more effective than CAU for primary care patients with PD or GAD.
BT - Psychotherapy and psychosomatics
C5 - Medically Unexplained Symptoms
CP - 1
CY - Switzerland
DO - 10.1159/000353682
IS - 1
JF - Psychotherapy and psychosomatics
N2 - BACKGROUND: Collaborative stepped care (CSC) may be an appropriate model to provide evidence-based treatment for anxiety disorders in primary care. METHODS: In a cluster randomised controlled trial, the effectiveness of CSC compared to care as usual (CAU) for adults with panic disorder (PD) or generalised anxiety disorder (GAD) in primary care was evaluated. Thirty-one psychiatric nurses who provided their services to 43 primary care practices in the Netherlands were randomised to deliver CSC (16 psychiatric nurses, 23 practices) or CAU (15 psychiatric nurses, 20 practices). CSC was provided by the psychiatric nurses (care managers) in collaboration with the general practitioner and a consultant psychiatrist. The intervention consisted of 3 steps, namely guided self-help, cognitive behavioural therapy and antidepressants. Anxiety symptoms were measured with the Beck Anxiety Inventory (BAI) at baseline and after 3, 6, 9 and 12 months. RESULTS: We recruited 180 patients with a DSM-IV diagnosis of PD or GAD, of whom 114 received CSC and 66 received usual primary care. On the BAI, CSC was superior to CAU [difference in gain scores from baseline to 3 months: -5.11, 95% confidence interval (CI) -8.28 to -1.94; 6 months: -4.65, 95% CI -7.93 to -1.38; 9 months: -5.67, 95% CI -8.97 to -2.36; 12 months: -6.84, 95% CI -10.13 to -3.55]. CONCLUSIONS: CSC, with guided self-help as a first step, was more effective than CAU for primary care patients with PD or GAD.
PP - Switzerland
PY - 2014
SN - 1423-0348; 0033-3190
SP - 37
EP - 44
EP - 
T1 - Effectiveness of collaborative stepped care for anxiety disorders in primary care: a pragmatic cluster randomised controlled trial
T2 - Psychotherapy and psychosomatics
TI - Effectiveness of collaborative stepped care for anxiety disorders in primary care: a pragmatic cluster randomised controlled trial
U1 - Medically Unexplained Symptoms
U2 - 24281396
U3 - 10.1159/000353682
VL - 83
VO - 1423-0348; 0033-3190
Y1 - 2014
ER -