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

被引：43

作者：

Camacho, Elizabeth M. ^{[1
]}

Davies, Linda M. ^{[1
]}

Hann, Mark ^{[1
]}

Small, Nicola ^{[1
]}

Bower, Peter ^{[2
]}

Chew-Graham, Carolyn ^{[1
,3
,4
]}

Baguely, Clare ^{[5
]}

Gask, Linda ^{[1
]}

Dickens, Chris M. ^{[6
]}

Lovell, Karina ^{[7
]}

Waheed, Waquas ^{[1
]}

Gibbons, Chris J. ^{[1
,8
]}

Coventry, Peter ^{[9
,10
]}

机构：

[1] Univ Manchester, Div Populat Hlth Hlth Serv Res & Primary Care, Manchester, Lancs, England

[2] Univ Manchester, NIHR Sch Primary Care Res, Manchester Acad Hlth Sci Ctr, Manchester, Lancs, England

[3] Keele Univ, Primary Care & Hlth Sci, Keele, Staffs, England

[4] NIHR Collaborat Leadership Appl Hlth Res & Care W, Nottingham, England

[5] NHS Hlth Educ North West, Manchester, Lancs, England

[6] Univ Exeter, Mental Hlth Res Grp, Exeter, Devon, England

[7] Univ Manchester, Div Nursing Midwifery & Social Work, Manchester Acad Hlth Sci Ctr, Manchester, Lancs, England

[8] Univ Cambridge, Psychometr Ctr, Cambridge, England

[9] Univ York, Dept Hlth Sci, York, N Yorkshire, England

[10] Univ York, Ctr Reviews & Disseminat, York, N Yorkshire, England

来源：

BRITISH JOURNAL OF PSYCHIATRY | 2018年 / 213卷 / 02期

关键词：

HEALTH-CARE; METAANALYSIS; DEPRESSION; EDUCATION; ACCURACY; IMPACT;

D O I：

10.1192/bjp.2018.70

中图分类号：

R749 [精神病学];

学科分类号：

100205 ;

摘要：

Background Collaborative care can support the treatment of depression in people with long-term conditions, but long-termbenefits 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 pound 13 069. Conclusions In the long term, collaborative care reduces depression and is potentially cost-effective at internationally accepted willingness-to-pay thresholds. (C) The Royal College of Psychiatrists 2018.

引用

页码：456 / 463

页数：8

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