Cost-effectiveness of a multicondition collaborative care intervention: a randomized controlled trial.

Archives of General Psychiatry
Wayne J KatonMichael Von Korff

Abstract

Patients with depression and poorly controlled diabetes mellitus, coronary heart disease (CHD), or both have higher medical complication rates and higher health care costs, suggesting that more effective care management of psychiatric and medical disease control might also reduce medical service use and enhance quality of life. To evaluate the cost-effectiveness of a multicondition collaborative treatment program (TEAMcare) compared with usual primary care (UC) in outpatients with depression and poorly controlled diabetes or CHD. Randomized controlled trial of a systematic care management program aimed at improving depression scores and hemoglobin A(1c) (HbA(1c)), systolic blood pressure (SBP), and low-density lipoprotein cholesterol (LDL-C) levels. Fourteen primary care clinics of an integrated health care system. Population-based screening identified 214 adults with depressive disorder and poorly controlled diabetes or CHD. Physician-supervised nurses collaborated with primary care physicians to provide treatment of multiple disease risk factors. Blinded assessments evaluated depressive symptoms, SBP, and HbA(1c) at baseline and at 6, 12, 18, and 24 months. Fasting LDL-C concentration was assessed at baseline and at 12 and 24...Continue Reading

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