A multidisciplinary primary care team consultation in a socio-economically deprived community: an exploratory randomised controlled trial.
BACKGROUND
Psychosocial problems in socioeconomically deprived communities are not always amenable to traditional medical approaches. Mothers living in these areas are a particularly vulnerable group. The objective of this study was to evaluate the effectiveness of a lengthened multi-disciplinary team consultation in primary care in reducing anxiety and depression in mothers.


METHODS
This was a prospective randomised controlled trial of a multidisciplinary team consultation against normal care. 94 mothers were recruited from three general practices from an area of extreme socio-economic deprivation. Mothers randomised into the intervention group attended a multidisciplinary consultation with up to four case-specific health care professionals. Consultations addressed medical, psychological and social problems and lasted up to one hour. Conventional primary care continued to be available to the intervention families. Control group families received normal primary care services. The outcomes measured were anxiety and depression as using the Hospital Anxiety and Depression Scale (HADS), health status using SF36v2, and quality of life using the abbreviated Schedule for the Evaluation of Individual Quality of Life (SEIQoL-DW) at baseline, 6 months and 12 months.


RESULTS
Ordered logistic regression was used to analyse the data. There was no significant difference found between intervention and control groups after 6 months and 12 months in all of the measured outcomes.


CONCLUSIONS
The new lengthened multi-disciplinary team consultation did not have any impact on the mental health, general health, and quality of life of mothers after 6 and 12 months. Other methods of primary health care delivery in socio-economically deprived communities need to be evaluated.
Division of Population Health Sciences, Royal College of Surgeons in Ireland, 120 St Stephens Green, Dublin 2, Ireland. wschan@rcsi.ie
Wai-Sun
WS
Chan
David L
DL
Whitford
Ronan
R
Conroy
David
D
Gibney
Brid
B
Hollywood
D000328:Adult; D001008:Anxiety Disorders / Q000175:diagnosis / Q000628:therapy*; D057186:Comparative Effectiveness Research; D003866:Depressive Disorder / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D006801:Humans; D016015:Logistic Models; D009035:Mothers / Q000523:psychology* / Q000706:statistics & numerical data; D017063:Outcome Assessment, Health Care; D010348:Patient Care Team; D011203:Poverty; D011320:Primary Health Care / Q000379:methods*; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012017:Referral and Consultation; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires
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