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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. | LitMetric

AI Article Synopsis

  • Collaborative care effectively supports depression treatment in individuals with mental-physical multimorbidity over a 24-month period.
  • In a trial involving 387 participants, collaborative care showed a significant reduction in depression symptoms and an increase in quality-adjusted life-years (QALYs) compared to usual care.
  • The cost-effectiveness analysis revealed that the cost per QALY gained was £13,069, suggesting that collaborative care may be a worthwhile investment in mental health treatment.

Article Abstract

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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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6429252PMC
http://dx.doi.org/10.1192/bjp.2018.70DOI Listing

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