Camacho, E, Small, N, Bower, P, Davies, L, Hann, M, Chew-Graham, CA, Baguley, C, Gask, L, Dickens, C, Lovell, K, Waheed, W and Coventry, P (2018) Long-term clinical and cost-effectiveness of collaborative care (vs. usual care): a cluster-randomised trial. British Journal of Psychiatry -Supplement-. pp. 1-8. ISSN 0960-5371

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Abstract

Background
Collaborative care can support the treatment of depression in people with long-term conditions, but long-term benefits and costs are unknown.

Aims
To explore the long-term (24-month) effectiveness and cost-effectiveness of collaborative care in people with mental-physical multimorbidity.

Method
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.

Results
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.

Conclusions
In the long term, collaborative care reduces depression and is potentially cost-effective at internationally accepted willingness-to-pay thresholds.

Item Type: Article
Additional Information: This is an author-produced electronic version of an article accepted for publication in the British Journal of Psychiatry. The definitive publisher-authenticated version is available online at http://bjp.rcpsych.org
Subjects: R Medicine > R Medicine (General)
R Medicine > RA Public aspects of medicine
Divisions: Faculty of Medicine and Health Sciences > Primary Care Health Sciences
Depositing User: Symplectic
Date Deposited: 21 Mar 2018 16:31
Last Modified: 09 Jul 2018 08:34
URI: http://eprints.keele.ac.uk/id/eprint/4634

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