Amy Coe, Noor Abid, Catherine Kaylor-Hughes
Social media group support for antidepressant deprescribing: a mixed-methods survey of patient experiences
Australian journal of primary health
background many people mental neurological substanceuse disorders mns receive health care nonspecialist health workers nshws professionals health roles ophrs key strategy closing treatment gap objectives assess effect nshws ophrs delivering mns interventions primary community health care low middleincome countries search methods searched cochrane central register controlled trials central including cochrane effective practice organisation care epoc group specialised register searched 21 june 2012 medline ovidsp medline process nonindexed citations ovidsp embase ovidsp searched 15 june 2012 cinahl ebscohost psycinfo ovidsp searched 18 19 june 2012 world health organization global health library searched 29 june 2012 lilacs international clinical trials registry platform opengrey metaregister controlled trials searched 8 9 august 2012 science citation index social sciences citation index isi web knowledge searched 2 october 2012 reference lists without language date restrictions contacted authors additional studies selection criteria randomised nonrandomised controlled trials controlled beforeandafter studies interruptedtimeseries studies nshwsophrdelivered interventions primarycommunity health care low middleincome countries intended improve outcomes people mns disorders carers defined nshw professional health worker eg doctors nurses social workers lay health worker without specialised training mns disorders ophrs included people outside health sector teachers review data collection analysis review authors double screened double dataextracted assessed risk bias using standard formats grouped studies similar interventions together feasible combined data obtain overall estimate effect main results 38 included studies seven low 15 middleincome countries twentytwo studies used lay health workers addressed depression posttraumatic stress disorder ptsd review shows use nshws compared usual healthcare services 1 may increase number adults recover depression anxiety two six months treatment prevalence depression risk ratio rr 030 95 confidence interval ci 014 064 lowquality evidence 2 may slightly reduce symptoms mothers perinatal depression severity depressive symptoms standardised mean difference smd 042 95 ci 058 026 lowquality evidence 3 may slightly reduce symptoms adults ptsd severity ptsd symptoms smd 036 95 ci 067 005 lowquality evidence 4 probably slightly improves symptoms people dementia severity behavioural symptoms smd 026 95 ci 060 008 moderatequality evidence 5 probably improvesslightly improves mental wellbeing burden distress carers people dementia carer burden smd 050 95 ci 084 015 moderatequality evidence 6 may decrease amount alcohol consumed people alcoholuse disorders drinksdrinking day last 7 30 days mean difference 168 95 ci 279 057 lowquality evidence uncertain whether lay health workers teachers reduce ptsd symptoms among children insufficient data draw conclusions costeffectiveness using nshws teachers impact people mns conditions addition studies measured adverse effects nshwled care effects could impact appropriateness quality care authors conclusions overall nshws teachers promising benefits improving peoples outcomes general perinatal depression ptsd alcoholuse disorders patient careroutcomes dementia however evidence mostly low low quality issues evidence available therefore cannot make conclusions specific nshwled interventions effective