Team-Centered Multicondition Care Deemed Cost-Effective

Collaborative care intervention lowers outpatient costs for comorbid psychiatric, medical disease

THURSDAY, May 10 (HealthDay News) -- For adults with depression and poorly controlled diabetes and/or coronary heart disease (CHD), a collaborative care intervention is cost-effective, according to a study published in the May issue of the Archives of General Psychiatry.

Wayne Katon, M.D., from the University of Washington in Seattle, and colleagues conducted a randomized controlled trial to assess the cost-effectiveness of a multicondition collaborative treatment program instituted at 14 primary care clinics of an integrated health care system. The study group included 214 adults with depressive disorder and poorly controlled diabetes or CHD. Depressive symptoms, systolic blood pressure (SBP), hemoglobin A1c (HbA1c), and low-density lipoprotein cholesterol (LDL-C) were evaluated at baseline and during 24 months of follow-up.

The researchers found that, over 24 months of follow-up, intervention patients had a mean of 114 additional depression-free days and an estimated 0.335 additional quality-adjusted life-years compared with controls receiving usual primary care. Compared with usual care patients, those in the intervention group also had lower mean outpatient health costs of $594 per patient.

"For adults with depression and poorly controlled diabetes, CHD, or both, a systematic intervention program aimed at improving depression scores and HbA1c, SBP, and LDL-C levels seemed to be a high-value program that for no or modest additional cost markedly improved quality-adjusted life-years," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

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