A RANDOMIZED CONTROLLED TRIAL AND COST-ANALYSIS OF PROBLEM-SOLVING TREATMENT FOR EMOTIONAL DISORDERS GIVEN BY COMMUNITY NURSES IN PRIMARY-CARE

Background We set out to investigate whether community nurses could be trained in problem-solving therapy and, once trained, how effective t hey would be in treating emotional disorders in primary care. Method S eventy patients with an emotional disorder in primary care were random ly allocated to receive either problem-solving therapy from a trained community nurse or treatment as usual from their general practitioner. Interview and self-rated assessments of clinical and economic outcome were made pre-treatment, at eight weeks and at 26 weeks after treatme nt. Results There was no difference in clinical outcome between patien ts who received problem-solving treatment and patients who received th e general practitioner's usual treatment. However, patients who receiv ed problem-solving treatment had fewer disability days and fewer days off work. The health care cost of problem-solving was greater than tha t of the general practitioner's usual treatment but this was more than offset by savings in the cost of days off work. Conclusions Problem-s olving treatment can be given by trained community nurses. the clinica l effectiveness and cost-benefit of the treatment will depend on the s election of appropriate patients.