A randomised controlled trial of a lengthened and multi-disciplinary consultation model in a socially deprived community: a study protocol.
BACKGROUND
There has been little development of the general practice consultation over the years, and many aspects of the present consultation do not serve communities with multiple health and social problems well. Many of the problems presenting to general practitioners in socio-economically disadvantaged areas are not amenable to a purely medical solution, and would particularly benefit from a multidisciplinary approach. Socio-economic deprivation is also associated with those very factors (more psychosocial problems, greater need for health promotion, more chronic diseases, more need for patient enablement) that longer consultations have been shown to address. This paper describes our study protocol, which aims to evaluate whether a lengthened multidisciplinary primary care team consultation with families in a socially deprived area can improve the psychological health of mothers in the families.


METHODS
In a randomised controlled trial, families with a history of social problems, substance misuse or depression are randomly allocated to an intervention or control group. The study is based in three general practices in a highly deprived area of North Dublin. Primary health care teams will be trained in conducting a multidisciplinary lengthened consultation. Families in the intervention group will participate in the new style multidisciplinary consultation. Outcomes of families receiving the intervention will be compared to the control group who will receive only usual general practitioner care. The primary outcome is the psychological health of mothers of the families and secondary outcomes include general health status, quality of life measures and health service usage.


CONCLUSIONS
The main aim of this study is to evaluate the effectiveness of a lengthened multidisciplinary team consultation in primary care. The embedded nature of this study in general practices in a highly deprived area ensures generalisability to other deprived communities, but more particularly it promises relevance to primary care.


BACKGROUND
Current Controlled Trials ISRCTN70578736.
Whitford
David L
DL
Family and Community Medicine, Royal College of Surgeons in Ireland-Medical University of Bahrain, Adliya, Kingdom of Bahrain. dwhitford@rcsi-mub.com
Chan
Wai-Sun
WS
D001007:Anxiety / Q000453:epidemiology; D003467:Cultural Deprivation; D003863:Depression / Q000453:epidemiology; D005194:Family Practice / Q000458:organization & administration*; D006801:Humans; D007494:Ireland; D017146:Models, Organizational; D009035:Mothers / Q000523:psychology; D010348:Patient Care Team / Q000458:organization & administration*; D011204:Poverty Areas; D011320:Primary Health Care / Q000458:organization & administration*; D015397:Program Evaluation; D012017:Referral and Consultation / Q000458:organization & administration*; D012111:Residence Characteristics; D012940:Social Problems; D013997:Time Factors; D035862:Vulnerable Populations