Pettit Sophie, Qureshi Adam, Lee William, Stirzaker Alex, Gibson Alex, Henley William, Byng Richard
College of Nursing, Midwifery and Healthcare, University of West London, London.
Department of Psychology, Edge Hill University, Ormskirk.
Br J Gen Pract. 2017 Jul;67(660):e453-e459. doi: 10.3399/bjgp17X691361. Epub 2017 Jun 5.
Older people with common mental health problems (CMHPs) are known to have reduced rates of referral to psychological therapy.
To assess referral rates to the Improving Access to Psychological Therapies (IAPT) services, contact with a therapist, and clinical outcome by age.
Empirical research study using patient episodes of care from South West of England IAPT services.
By analysing 82 513 episodes of care (2010-2011), referral rates and clinical improvement were compared with both total population and estimated prevalence in each age group using IAPT data. Probable recovery of those completing treatment was calculated for each group.
Estimated prevalence of CMHPs peaks in 45-49-year-olds (20.59% of population). The proportions of patients identified with CMHPs being referred peaks at 20-24 years (22.95%) and reduces with increase in age thereafter to 6.00% for 70-74-year-olds. Once referred, the proportion of those attending first treatment increases with age between 20 years (57.34%) and 64 years (76.97%). In addition, the percentage of those having a clinical improvement gradually increases from the age of 18 years (12.94%) to 69 years (20.74%).
Younger adults are more readily referred to IAPT services. However, as a proportion of those referred, probabilities of attending once, attending more than once, and clinical improvement increase with age. It is uncertain whether optimum levels of referral have been reached for young adults. It is important to establish whether changes to service configuration, treatment options, and GP behaviour can increase referrals for middle-aged and older adults.
已知患有常见心理健康问题（CMHP）的老年人接受心理治疗的转诊率较低。
按年龄评估改善心理治疗可及性（IAPT）服务的转诊率、与治疗师的接触情况及临床结局。
利用英格兰西南部IAPT服务的患者护理记录进行实证研究。
通过分析82513份护理记录（2010 - 2011年），使用IAPT数据将转诊率和临床改善情况与各年龄组的总人口及估计患病率进行比较。计算每组完成治疗者的可能康复情况。
CMHP的估计患病率在45 - 49岁人群中达到峰值（占人口的20.59%）。被确诊患有CMHP的患者转诊比例在20 - 24岁达到峰值（22.95%），此后随年龄增长而降低，70 - 74岁人群降至6.00%。一旦转诊，首次接受治疗的比例在20岁（57.34%）至64岁（76.97%）之间随年龄增长而增加。此外，临床改善的百分比从18岁（12.94%）逐渐增至69岁（20.74%）。
年轻人更易被转诊至IAPT服务。然而，就转诊者而言，就诊一次、多次就诊及临床改善的可能性随年龄增长而增加。尚不确定年轻人是否已达到最佳转诊水平。确定服务配置、治疗选择及全科医生行为的改变是否能增加中年及老年人群的转诊量很重要。
