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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.
Camacho, Elizabeth M; Davies, Linda M; Hann, Mark; Small, Nicola; Bower, Peter; Chew-Graham, Carolyn; Baguely, Clare; Gask, Linda; Dickens, Chris M; Lovell, Karina; Waheed, Waquas; Gibbons, Chris J; Coventry, Peter.
Afiliación
  • Camacho EM; Division of Population Health,Health Services Research, and Primary Care,The University of Manchester,UK.
  • Davies LM; Division of Population Health,Health Services Research, and Primary Care,The University of Manchester,UK.
  • Hann M; Division of Population Health,Health Services Research, and Primary Care,The University of Manchester,UK.
  • Small N; Division of Population Health,Health Services Research, and Primary Care,The University of Manchester,UK.
  • Bower P; NIHR School for Primary Care Research,The University of Manchester,Manchester Academic Health Science Centre,UK.
  • Chew-Graham C; Primary Care & Health Sciences,University of Keele,UK,Division of Population Health, Health Services Research, and Primary Care,The University of Manchester,UKand NIHR Collaboration for Leadership in Applied Health Research and Care West Midlands,UK.
  • Baguely C; NHS Health Education North West,Manchester,UK.
  • Gask L; Division of Population Health, Health Services Research, and Primary Care,The University of Manchester,UK.
  • Dickens CM; Mental Health Research Group,University of Exeter,UK.
  • Lovell K; Division of Nursing, Midwifery and Social Work,The University of Manchester,Manchester Academic Health Science Centre,UK.
  • Waheed W; Division of Population Health,Health Services Research, and Primary Care,The University of Manchester,UK.
  • Gibbons CJ; The Psychometrics Centre,University of Cambridge,UKand Division of Population Health,Health Services Research, and Primary Care,The University of Manchester,UK.
  • Coventry P; Department of Health Sciences,University of York,UKand Centre for Reviews and Dissemination,University of York,UK.
Br J Psychiatry ; 213(2): 456-463, 2018 08.
Article en En | MEDLINE | ID: mdl-29761751
BACKGROUND: 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. 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.Declaration of interestNone.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Grupo de Atención al Paciente / Atención Primaria de Salud / Prestación Integrada de Atención de Salud / Enfermedad Coronaria / Complicaciones de la Diabetes / Depresión Tipo de estudio: Clinical_trials / Health_economic_evaluation / Prognostic_studies Aspecto: Patient_preference Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Br J Psychiatry Año: 2018 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Grupo de Atención al Paciente / Atención Primaria de Salud / Prestación Integrada de Atención de Salud / Enfermedad Coronaria / Complicaciones de la Diabetes / Depresión Tipo de estudio: Clinical_trials / Health_economic_evaluation / Prognostic_studies Aspecto: Patient_preference Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Br J Psychiatry Año: 2018 Tipo del documento: Article Pais de publicación: Reino Unido