Eight RCTs (3,864 patients) were included in the review.
Study quality scores ranged from 32 to 44 (mean 38). Sample sizes ranged from 96 to 1801. Follow-up ranged from 11 weeks to 24 months, and drop-out rates were lower for Geriatric Evaluation Management studies.
Four studies (954 patients) used the Geriatric Evaluation Management model. Two of these reported on short- and long-term follow-up from the same trial, revealing a medium to large effect size for symptom reduction at 12 months and a smaller one at 24 months: 0.59 and 0.20, respectively. One other study showed symptom reduction at 18 months, but the estimated effect size (0.20) was small. The fourth study showed no difference in effect between intervention and control groups.
Four studies (2,910 patients) used the Integrated Health Care model. Three of these reported symptom reduction in the intervention groups, although effect sizes were classed as medium in only one (0.47 at 3 months and 0.57 at 12 months). One study also reported decreased suicidal ideation (result not reported).