Meta Analysis Of The Efficacy Of Collaboration Care Model On Depression Of Elderly Wiht Chronic Diseases

Objective:To evaluate the effect of collaborative care model on improving the depression of the elderly patients with chronic diseases in different periods of community,and to provide a reference for the use of collaborative care model in Chinese community,and to promote the development of primary care health care in our country.Methods:Collecting clinical randomized controlled trials of collaborative care model on improving the depression of the elderly patients with chronic diseases in community which published from establishing to October 2019,by searching the PubMed,Web of science,EBSCOhost,SinoMed,CNKI,VIP and Wan fang Databases.According to the title,abstract and keywords,the literature was preliminarily screened and retrieved,unqualified and repeatedly published literatures were excluded,and the full text was further read to exclude those that did not meet the inclusion criteria.If two researchers disagree during the evaluation process,a resolution is negotiated with the third researcher.Using EndNote X9 software for managing literatures,and RevMan 5.3 software for analysising data,conducting heterogeneity test,and publishing migration test.The forest map were shown of the final results.Results:(1)10 articles were included in the meta-analysis,with including a total of 3892 cases 1,961 cases in the experimental group and 1,931 cases in the control group.Five studies were randomly assigned by random number table or random number generator or computer;Five studies described how allocation hiding works;Five studies were blind to study subjects or participants;Four studies blinded test takers;nine studies reported the loss of follow-up.According to Cochrane Handbook(5.1.0),the quality evaluation of the included literature was all grade B,and the quality score of the modified Jadad scale for the included literature was 3～6,indicating that the overall quality of the literature was mediocre.(2)The meta-analysis results showed that the short-term intervention of collaborative nursing mode had a better effect on the depression level of elderly patients with chronic diseases in the community than the control group[SMD=-0.95,95%CI(-1.54,-0.35),P<0.001];The medium-term intervention of collaborative nursing mode had a better effect on the depression level of elderly patients with chronic diseases in the community than the control group[SMD=-1.55,95%CI(-2.36,-0.74),P<0.001];The long-term intervention of collaborative nursing mode had a better effect on the depression level of elderly patients with chronic diseases in the community than the control group[SMD=-0.44,95%CI(-0.66,-0.22),P<0.001].Conclusion:The collaborative nursing model can effectively improve the depression of the elderly with chronic diseases in the community,and the intervention effect on depression level is significant in the short,medium and long term.