Long-term clinical and cost-effectiveness of collaborative care (versus usual care) for people with mental-physical multimorbidity: cluster-randomised trial

The British Journal of Psychiatry : the Journal of Mental Science
Elizabeth M CamachoPeter Coventry

Abstract

Collaborative care can support the treatment of depression in people with long-term conditions, but long-term benefits and costs are unknown.AimsTo explore the long-term (24-month) effectiveness and cost-effectiveness of collaborative care in people with mental-physical multimorbidity. A cluster randomised trial compared collaborative care (integrated physical and mental healthcare) with usual care for depression alongside diabetes and/or coronary heart disease. Depression symptoms were measured by the symptom checklist-depression scale (SCL-D13). The economic evaluation was from the perspective of the English National Health Service. 191 participants were allocated to collaborative care and 196 to usual care. At 24 months, the mean SCL-D13 score was 0.27 (95% CI, -0.48 to -0.06) lower in the collaborative care group alongside a gain of 0.14 (95% CI, 0.06-0.21) quality-adjusted life-years (QALYs). The cost per QALY gained was £13 069. In the long term, collaborative care reduces depression and is potentially cost-effective at internationally accepted willingness-to-pay thresholds.Declaration of interestNone.

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Citations

Apr 27, 2019·The British Journal of Psychiatry : the Journal of Mental Science·Parashar Pravin Ramanuj, Harold Alan Pincus
Jul 8, 2020·The European Journal of Health Economics : HEPAC : Health Economics in Prevention and Care·Stephen RocksApostolos Tsiachristas
Aug 9, 2020·Translational Behavioral Medicine·Alison C ShmerlingBenjamin F Miller
Aug 20, 2019·Journal of Community Psychology·Lauren M KaplanMargot B Kushel
Dec 12, 2018·International Clinical Psychopharmacology·Giovanni OstuzziCorrado Barbui
Jan 21, 2019·Current Psychiatry Reports·Parashar RamanujHarold Alan Pincus
Dec 10, 2020·International Journal of Mental Health Systems·C EeJ Sarris

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