This review addressed a clear question and the inclusion and exclusion criteria were clear. A broad range of interventions were included. The authors searched two databases and reference lists. In view of the nature of the interventions being evaluated this search appears limited, as relevant studies could be published in sources not covered by the main medical databases. It appears that the search was limited to English language papers and that unpublished studies were not sought, so the review may be at risk of language and publication bias. The validity of the included studies was assessed using appropriate criteria (although blinding is not possible for this type of intervention). Adequate details of the included studies were presented. Appropriate methods were used to minimise errors and bias in the study selection process, but it is not clear whether the same methods were applied to the validity assessment and data extraction. The data were synthesised narratively, which was appropriate in view of the heterogeneity of the included interventions and quality-of-life instruments.
The authors' overall conclusion is in line with the evidence presented and seems appropriate in view of the mixed results of the included RCTs. The secondary conclusion, about the positive effects of primary care involvement, should be treated with caution because the interventions that involved primary care also had a secondary care component and it is difficult to be certain which components were responsible for the observed effects.