Brief problem-solving treatment in primary care (PST-PC) was not more effective than placebo for elderly patients screened positive of psychological problems.
OBJECTIVE
To evaluate whether screening followed by brief problem-solving treatment by primary care doctors (PST-PC) could improve health-related quality of life (HRQOL) and reduce consultation rates in the elderly.


METHODS
A single-blind randomized placebo controlled trial (RCT).


METHODS
Two government funded primary care clinics in Hong Kong.


METHODS
Two hundred and ninety nine Chinese patients aged 60 years or over, with positive screening scores for psychological problems by the Hospital Anxiety and Depression Scale (HADS).


METHODS
One hundred and forty nine subjects were randomized to receive brief PST-PC from primary care doctors (treatment) and 150 to group video-viewing (placebo). All subjects were followed up by telephone at 6, 12, 26 and 52 weeks.


METHODS
Changes in SF-36 HRQOL scores, HADS scores and monthly consultation rates were compared within and between groups.


RESULTS
Study completion rates were 69-71%. There was significant improvement in the SF-36 role-emotional (RE) and mental component summary (MCS) scores at week 6 in the PST-PC group but not in the placebo group. Several SF-36 scores improved significantly in the placebo (video) group at week 6-52. Mixed effects analysis adjusting for baseline values and cofounders did not show any difference in any of the outcomes between the PST-PC and placebo (video) groups.


CONCLUSIONS
Screening followed by brief PST-PC was associated with a short-term improvement in HRQOL in Chinese elderly patients screened positive of psychological problems, but the HRQOL benefit was not greater than those found in the placebo group who participated in group-viewings of health education videos.
Lam
Cindy L K
CL
Family Medicine Unit, The University of Hong Kong, Hong Kong. clklam@hku.hk
Fong
Daniel Y T
DY
Chin
Weng-Yee
WY
Lee
Peter W H
PW
Lam
Elegance T P
ET
Lo
Yvonne Y C
YY
D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D005260:Female; D006266:Health Education / Q000379:methods; D006304:Health Status; D006723:Hong Kong; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010353:Patient Education as Topic / Q000379:methods; D011320:Primary Health Care; D011340:Problem Solving; D011569:Psychiatric Status Rating Scales; D011614:Psychotherapy, Brief / Q000379:methods* / Q000592:standards*; D011788:Quality of Life; D016037:Single-Blind Method; D014741:Video Recording