The effectiveness of suicide prevention delivered by GPs: A systematic review and meta-analysis

JOURNAL OF AFFECTIVE DISORDERS

卷:210

Article

Milner, Allison^1,2  Witt, Katrina³  Pirkis, Jane⁴  Hetrick, Sarah⁵  Robinson, Jo⁵  Currier, Dianne⁴  Spittal, Matthew J.⁴  Page, Andrew⁶  Carter, Gregory L.⁷ 

[1] Univ Melbourne, Ctr Hlth Equ, Melbourne Sch Populat & Global Hlth, Melbourne, Vic, Australia

[2] Deakin Univ, Populat Hlth Res Ctr, Sch Hlth & Social Dev, Work Hlth & Wellbeing Unit, Melbourne, Vic, Australia

[3] Monash Univ, Turning Point, Melbourne, Vic, Australia

[4] Univ Melbourne, Ctr Mental Hlth, Melbourne Sch Populat & Global Hlth, Melbourne, Vic, Australia

[5] Univ Melbourne, Orygen Natl Ctr Excellence Youth Mental Hlth, Melbourne, Vic, Australia

[6] Univ Western Sydney, Ctr Hlth Res, Sch Med, Sydney, NSW, Australia

[7] Univ Newcastle, Fac Hlth & Med, Ctr Brain & Mental Hlth Res, Newcastle, NSW, Australia

关键词: General practice;    Suicide prevention;    Self-harm;    Suicide attempt;    Suicide ideation;    Doctor suicide prevention;   

DOI  :  10.1016/j.jad.2016.12.035

来源: Elsevier

【 摘 要 】

Background: The aim of this review was to assess whether suicide prevention provided in the primary health care setting and delivered by GPs results in fewer suicide deaths, episodes of self-harm, attempts and lower frequency of thoughts about suicide. Methods: We conducted a systematic review and meta-analysis using PRISMA guidelines. Eligible studies: 1) evaluated an intervention provided by GPs; 2) assessed suicide, self-harm, attempted suicide or suicide ideation as outcomes, and; 3) used a quasi-experimental observational or trial design. Study specific effect sizes were combined using the random effects meta-analysis, with effects transformed into relative risk (RR). Results: We extracted data from 14 studies for quantitative meta-analysis. The RR for suicide death in quasi experimental observational studies comparing an intervention region against another region acting as a control was 1.26 (95% CI 0.58, 2.74). When suicide in the intervention region was compared before and after the GP program, the RR was 0.78 (95% CI 0.62, 0.97). There was no evidence of a treatment effect for GP training on rates of suicide death in one cRCT (RR 1.07, 95% CI 0.79, 1.45). There was no evidence of effect for the most other outcomes studied. Limitations: All of the studies included in this review are likely to have a high level of bias. It is also possible that we excluded or missed relevant studies in our review process Conclusions: Interventions have produced equivocal results, which varied by study design and outcome. Given these results, we cannot recommend the roll out of GP suicide prevention initiatives.

【 授权许可】

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