Authors' objectives:

To identify and appraise international evidence for the effectiveness of geriatric psychiatry services.

Authors' recommendations: The following conclusions are based on the current evidence available from this report's critical appraisal of literature published on the effectiveness of geriatric psychiatry services. The most positive outcomes of geriatric psychiatry services were noted in community settings, with moderate to large intervention effect sizes evident, particularly for multidisciplinary team assessment and treatment of depression and comprehensive case-management of dementia. Geriatric psychiatry services for inpatient settings were generally effective, with multidisciplinary team approaches in specialist geriatric psychiatry units showing the greatest success in the patient outcomes evaluated. Behaviour management programmes within specialist units performed by multidisciplinary teams were also effective. Consultation liaison interventions in these settings showed more mixed results. For patients as well as caregivers, comprehensive services (including training and education in addition to assessment and treatment) provided by a multidisciplinary team, tailored to individual need, appear to be most effective. To patients and caregivers, effective geriatric psychiatry services are those that are: - comprehensive in their scope, with an holistic or 'bio-psycho-socio-cultural' approach to assessment, treatment and management - staffed by competent and knowledgeable health professionals - supported by informed families and communities - tailored, flexible and responsive to individual need (culturally appropriate, at home) - provided by a multidisciplinary team There are limitations in the available research base and the evaluation of geriatric psychiatry services. What is published, despite being the best currently available, is at times difficult material to draw strong conclusions about service effectiveness. Studies in primary care, rural settings and also with minority or ethnic groups are lacking. These limitations do not necessarily indicate lack of effectiveness, but rather highlight the lack of research in these areas especially research specific to the New Zealand context.

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://nzhta.chmeds.ac.nz/publications.htm

Year Published: 2004

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: New Zealand

Organisation Name: New Zealand Health Technology Assessment

Contact Address: Department of Public Health and General Practice, Christchurch School of Medicine and Health Sciences, University of Otago, P.O. Box 4345, Christchurch, New Zealand. Tel: +64 3 364 1145; Fax: +64 3 364 1152;

Contact Name: nzhta@chmeds.ac.nz

Contact Email: nzhta@chmeds.ac.nz

Copyright: New Zealand Health Technology Assessment (NZHTA)