title: Collaborative care for depression in primary care. Making sense of a complex intervention: systematic review and meta-regression.
abstract: BACKGROUND
  The management of depression in primary care is a significant issue for health services worldwide. "Collaborative care" interventions are effective, but little is known about which aspects of these complex interventions are essential.
  
  
  OBJECTIVE
  To use meta-regression to identify "active ingredients" in collaborative care models for depression in primary care.
  
  
  METHODS
  Studies were identified using systematic searches of electronic databases. The content of collaborative care interventions was coded, together with outcome data on antidepressant use and depressive symptoms. Meta-regression was used to examine relationships between intervention content and outcomes.
  
  
  RESULTS
  There was no significant predictor of the effect of collaborative care on antidepressant use. Key predictors of depressive symptom outcomes included systematic identification of patients, professional background of staff and specialist supervision.
  
  
  CONCLUSIONS
  Meta-regression may be useful in examining "active ingredients" in complex interventions in mental health.
authors.affiliation: National Primary Care Research and Development Centre, University of Manchester, Manchester M13 9PL, UK. peter.bower@manchester.ac.uk
authors.forename: Peter
authors.initials: P
authors.lastname: Bower
authors.forename: Simon
authors.initials: S
authors.lastname: Gilbody
authors.forename: David
authors.initials: D
authors.lastname: Richards
authors.forename: Janine
authors.initials: J
authors.lastname: Fletcher
authors.forename: Alex
authors.initials: A
authors.lastname: Sutton
mesh_terms: D003866:Depressive Disorder / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D007400:Interprofessional Relations; D008605:Mental Health Services / Q000592:standards*; D010348:Patient Care Team / Q000592:standards*; D011320:Primary Health Care / Q000592:standards*; D016896:Treatment Outcome