Long-term clinical and cost-effectiveness of collaborative care (versus usual care) for people with mental-physical multimorbidity: cluster-randomised trial
Long-term clinical and cost-effectiveness of collaborative care (versus usual care) for people with mental-physical multimorbidity: cluster-randomised trial
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DOI：
10.1192/bjp.2018.70
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发表时间：
2018-08-01
影响因子：
10.5
通讯作者：
Coventry, Peter
中科院分区：
文献类型：
--
作者：
Camacho, Elizabeth M.;Davies, Linda M.;Coventry, Peter
背景协作护理可以支持长期抑郁症患者的治疗，但长期的收益和成本是未知的。目的是探索长期的协作治疗在精神-身体多Mortimorrhoeal患者中的24个月的有效性和成本效益。（综合身心保健）与抑郁症以及糖尿病和/或冠心病的常规护理。采用症状自评量表-抑郁量表（SCL-D13）评定抑郁症状。结果191名参与者被分配到合作护理，196名参与者被分配到常规护理。在24个月时，协作护理组的平均SCL-D13评分低0.27（95%CI，-0.48至-0.06），同时质量调整生命年（Qs）增加0.14（95%CI，0.06-0.21）。每增加一个QALY的成本为13 069磅。结论从长远来看，协作护理可以减少抑郁症，并且在国际公认的支付意愿阈值下可能具有成本效益。(C)2018年皇家精神科医学院。
BackgroundCollaborative care can support the treatment of depression in people with long-term conditions, but long-termbenefits and costs are unknown.AimsTo explore the long-term (24-month) effectiveness and cost-effectiveness of collaborative care in people with mental-physical multimorbidity.MethodA 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.Results191 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.ConclusionsIn 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.