Camacho, EM, Davies, LM, Hann, M, Small, N, Bower, P, Chew-Graham, C, Baguely, C, Gask, L, Dickens, CM, Lovell, K, Waheed, W, Gibbons, CJ and Coventry, P (2018) Long-term clinical and cost-effectiveness of collaborative care (versus usual care) for people with mental–physical multimorbidity: cluster-randomised trial. British Journal of Psychiatry, 213 (2). pp. 456-463. ISSN 0007-1250

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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 the final published version of the article (version of record). It first appeared online via Royal College of Psychiatrists at https://doi.org/10.1192/bjp.2018.70 - please refer to any applicable terms of use of the publisher.
Uncontrolled Keywords: health care, meta-analysis, depression, education, accuracy, impact
Subjects: R Medicine > RC Internal medicine > RC435 Psychiatry
Divisions: Faculty of Medicine and Health Sciences > Institute for Science and Technology in Medicine
Depositing User: Symplectic
Date Deposited: 21 May 2018 13:33
Last Modified: 28 Aug 2018 13:12
URI: http://eprints.keele.ac.uk/id/eprint/4930

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