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Q Does case management in community based care improve symptoms and medication adherence in people with depression?
Systematic review with meta-analyses.
MEDLINE, EMBASE, and the Cochrane Library, plus hand searches of reference lists and contact with experts; search date May 2003.
Study selection and analysis:
Eligible studies were community based, randomised controlled trials (RCTs) with a follow up period of 6–12 months, comparing the effect of case management (monitoring progress with remedial action to address problems) versus standard care in people with major depression or depressive episodes (DSM-V or ICD-10). Main exclusions: poor methodological quality; interventions aimed at healthcare professionals, relatives, or depression in special situations (drug abuse, homelessness, disability, pregnancy or end of life). Meta-analyses using a random effects model. Dichotomous outcomes (remission, response, adherence) were combined using weighted relative risks. The effect of case management on symptoms was calculated as the standardised …
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