Randomised controlled trials (RCTs) that described interventions in frequent attenders older than 14 years in primary care (defined as all first points of consultation sites, non in-hospital care) were eligible for inclusion. All possible frequent attender definitions were included, including definitions based on specific subgroups of primary care patients.
The included studies were performed in primary care clinics, primary healthcare for students and at a primary care out of hours service. The age range of frequent attenders varied from 18 to 75 years where reported. Definitions for frequent attenders varied. Included interventions were: depression management programmes; a psychiatric consultation-liaison programme; an educational programme; and a combination of intervention strategies. Outcomes measured included depression-free days, costs, Hamilton Depression Rating Scale score, use of antidepressant medication, rate of anxiety/depression, use of healthcare, SF-20 and number of contacts.
Two reviewers independently selected studies for inclusion. The final selection was performed in consensus with a third reviewer.