Evidence map›Paper›PMID 22566583›Full record

Trial reportArchives of general psychiatry2012

Cost-effectiveness of a multicondition collaborative care intervention: a randomized controlled trial.

Wayne Katon, Joan Russo, Elizabeth H B Lin, Julie Schmittdiel, Paul Ciechanowski, Evette Ludman, Do Peterson, Bessie Young, Michael Von Korff

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Archives of general psychiatry, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00468676 (Randomized Trial of Liaison Psychiatry in Primary Care), which is not on this map. Cited by 136 papers, 22 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
136citing papers in PubMed, 22 pooled it
21.0field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00468676 nacompletednot on this map

Randomized Trial of Liaison Psychiatry in Primary Care

TypeinterventionalSponsorUniversity of WashingtonRan2007 to 2012Enrolled214ConditionsDepressionArmsNurse-led case management, Treatment as usual
3 · Its place in the literature

Who cites it

136 citing papers in PubMed, 22 syntheses or guidelines pooled it, 288 citations in OpenAlex.

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76 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 1 institution in 1 country.

Wayne KatonDepartment of Psychiatry and Behavioral Sciences, Box 356560, University of Washington School of Medicine, Seattle, WA 98195-6560, USA. wkaton@uw.edu
Joan Russo
Elizabeth H B Lin
Julie Schmittdiel
Paul Ciechanowski
Evette Ludman
Do Peterson
Bessie Young
Michael Von Korff
University of Washington · US

Funding

RANDOMIZED TRIAL OF LIAISON PSYCHIATRY IN PRIMARY CARER01MH041739 · NIMH · UNIVERSITY OF WASHINGTON · PI KATON, WAYNE J · 1987 to 2010
$6.6M
Population-Based Psychiatric Intervention--Primary CareK24MH069471 · NIMH · UNIVERSITY OF WASHINGTON · PI KATON, WAYNE J · 2004 to 2011
$1.0M
Quality Improvement of School Mental Health ServicesK08MH069741 · NIMH · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI KATAOKA, SHERYL H · 2004 to 2008
$769k
NIMH NIH HHS K08 MH069741NIMH NIH HHS K24 MH069471NIMH NIH HHS MH041739NIMH NIH HHS MH069741NIMH NIH HHS R01 MH041739
6 · The paper itself

Abstract

contextPatients with depression and poorly controlled diabetes mellitus, coronary heart disease (CHD), or both have higher medical complication rates and higher health care costs, suggesting that more effective care management of psychiatric and medical disease control might also reduce medical service use and enhance quality of life.

objectiveTo evaluate the cost-effectiveness of a multicondition collaborative treatment program (TEAMcare) compared with usual primary care (UC) in outpatients with depression and poorly controlled diabetes or CHD.

designRandomized controlled trial of a systematic care management program aimed at improving depression scores and hemoglobin A(1c) (HbA(1c)), systolic blood pressure (SBP), and low-density lipoprotein cholesterol (LDL-C) levels.

settingFourteen primary care clinics of an integrated health care system. PATIENTS: Population-based screening identified 214 adults with depressive disorder and poorly controlled diabetes or CHD.

interventionPhysician-supervised nurses collaborated with primary care physicians to provide treatment of multiple disease risk factors.

main outcome measuresBlinded assessments evaluated depressive symptoms, SBP, and HbA(1c) at baseline and at 6, 12, 18, and 24 months. Fasting LDL-C concentration was assessed at baseline and at 12 and 24 months. Health plan accounting records were used to assess medical service costs. Quality-adjusted life-years (QALYs) were assessed using a previously developed regression model based on intervention vs UC differences in HbA(1c), LDL-C, and SBP levels over 24 months.

resultsOver 24 months, compared with UC controls, intervention patients had a mean of 114 (95% CI, 79 to 149) additional depression-free days and an estimated 0.335 (95% CI, -0.18 to 0.85) additional QALYs. Intervention patients also had lower mean outpatient health costs of $594 per patient (95% CI, -$3241 to $2053) relative to UC patients.

conclusionsFor adults with depression and poorly controlled diabetes, CHD, or both, a systematic intervention program aimed at improving depression scores and HbA(1c), SBP, and LDL-C levels seemed to be a high-value program that for no or modest additional cost markedly improved QALYs.

trial registrationclinicaltrials.gov Identifier: NCT00468676

Indexed as

Blood PressureCholesterol, LDLCoronary DiseaseCost-Benefit AnalysisDepressive DisorderDiabetes ComplicationsDiabetes MellitusFemaleGlycated HemoglobinHealth Care CostsHumansMaleMiddle AgedPatient Care TeamCholesterol, LDLGlycated Hemoglobinhemoglobin A1c protein, human

Identifiers

PMID22566583
PMCPMC3840955
OpenAlexW2095598339

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.