494 Primary care consultation liaison effective for mental disorders

December 04, 2016

written by Brian R McAvoy

Clinical question
Compared with standard care and collaborative care, how effective is consultation liaison in primary care for people with mental disorders?

Bottom line
Consultation liaison improved mental health for up to 3 months, and satisfaction and adherence for up to 12 months in people with mental disorders, particularly those who had depression. Primary care providers were also more likely to provide adequate treatment and prescribe pharmacological therapy for up to 12 months. There was also some evidence that consultation liaison might not be as effective as collaborative care in terms of mental disorder symptoms, disability, general health status and provision of treatment.

Caveat
The quality of these findings was low for all outcomes apart from consumer adherence, which was of moderate quality. No conclusions could be made regarding the use of consultation liaison with people who have other mental disorders, such as schizophrenia or bipolar disorder. There were also no data which could inform practice with specific groups of people, such as children and adolescents, and the elderly.

Context
Despite the prevalence and negative impacts of mental disorders, many people are not diagnosed or do not receive adequate treatment. Consultation liaison is a model of mental healthcare where the primary care provider maintains the central role in the delivery of mental health care, with a mental health specialist providing consultative support. Consultation liaison has the potential to enhance the delivery of mental healthcare in the primary care setting and to improve outcomes for people with a mental disorder.

Cochrane Systematic Review
Gillies D et al. Consultation liaison in primary care for people with mental disorders. Cochrane Reviews, 2015, Issue 9. Art. No.: CD007193.DOI: 10.1002/14651858. CD007193.pub2. This review contains 12 studies involving 2605 consumer participants and over 905 primary care practitioners.

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.