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

Chew-Graham, Carolyn

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


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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.

Acceptance Date Mar 14, 2018
Publication Date Aug 1, 2018
Publicly Available Date Mar 28, 2024
Journal British Journal of Psychiatry
Print ISSN 0007-1250
Publisher Royal College of Psychiatrists
Pages 456-463
DOI https://doi.org/10.1192/bjp.2018.70
Keywords health care, meta-analysis, depression, education, accuracy, impact
Publisher URL https://doi.org/10.1192/bjp.2018.70

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