Evidence map›Paper›PMID 27855101›Full record

Trial reportBMJ open2016

Long-term cost-effectiveness of collaborative care (vs usual care) for people with depression and comorbid diabetes or cardiovascular disease: a Markov model informed by the COINCIDE randomised controlled trial.

Elizabeth M Camacho, Dionysios Ntais, Peter Coventry, Peter Bower, Karina Lovell, Carolyn Chew-Graham, Clare Baguley, Linda Gask, Chris Dickens, Linda M Davies

Open access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed, 5 pooled it
15.1field-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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

23 citing papers in PubMed, 5 syntheses or guidelines pooled it, 44 citations in OpenAlex.

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  11. Mental health and kidney disease.Nature reviews. Nephrology · 2026
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  20. Cost-Effectiveness of a Technology-Facilitated Depression Care Management Adoption Model in Safety-Net Primary Care Patients with Type 2 Diabetes.Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research · 2018
    Article
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

10 authors at 6 institutions in 1 country.

Elizabeth M CamachoManchester Centre for Health Economics, University of Manchester, Manchester, UK.
Dionysios NtaisManchester Centre for Health Economics, University of Manchester, Manchester, UK.
Peter CoventryMental Health and Addiction Research Group, University of York, York, UK.
Peter BowerCentre for Primary Care, University of Manchester, Manchester, UK.
Karina LovellThe School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK.
Carolyn Chew-GrahamPrimary Care & Health Sciences, University of Keele, Staffordshire, UK.
Clare BaguleyNHS Health Education North West, Manchester, UK.
Linda GaskCentre for Primary Care, University of Manchester, Manchester, UK.
Chris DickensMental Health Research Group, University of Exeter, Exeter, UK.
Linda M DaviesManchester Centre for Health Economics, University of Manchester, Manchester, UK.
University of Manchester · GBManchester Academic Health Science Centre · GBHealth Education North West · GBKeele University · GBUniversity of Exeter · GBUniversity of York · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo evaluate the long-term cost-effectiveness of collaborative care (vs usual care) for treating depression in patients with diabetes and/or coronary heart disease (CHD).

setting36 primary care general practices in North West England.

participants387 participants completed baseline assessment (collaborative care: 191; usual care: 196) and full or partial 4-month follow-up data were captured for 350 (collaborative care: 170; usual care: 180). 62% of participants were male, 14% were non-white. Participants were aged ≥18 years, listed on a Quality and Outcomes Framework register for CHD and/or type 1 or 2 diabetes mellitus, with persistent depressive symptoms. Patients with psychosis or type I/II bipolar disorder, actively suicidal, in receipt of services for substance misuse, or already in receipt of psychological therapy for depression were excluded.

interventionCollaborative care consisted of evidence-based low-intensity psychological treatments, delivered over 3 months and case management by a practice nurse and a Psychological Well Being Practitioner. OUTCOME MEASURES: As planned, the primary measure of cost-effectiveness was the incremental cost-effectiveness ratio (cost per quality-adjusted life year (QALY)). A Markov model was constructed to extrapolate the trial results from short-term to long-term (24 months).

resultsThe mean cost per participant of collaborative care was £317 (95% CI 284 to 350). Over 24 months, it was estimated that collaborative care was associated with greater healthcare usage costs (net cost £674 (95% CI -30 953 to 38 853)) and QALYs (net QALY gain 0.04 (95% CI -0.46 to 0.54)) than usual care, resulting in a cost per QALY gained of £16 123, and a likelihood of being cost-effective of 0.54 (willingness to pay threshold of £20 000).

conclusionsCollaborative care is a potentially cost-effective long-term treatment for depression in patients with comorbid physical and mental illness. The estimated cost per QALY gained was below the threshold recommended by English decision-makers. Further, long-term primary research is needed to address uncertainty associated with estimates of cost-effectiveness. TRIAL REGISTRATION NUMBER: ISRCTN80309252; Post-results.

Indexed as

Cooperative BehaviorCost-Benefit AnalysisPatient Care TeamAdolescentAdultAgedAged, 80 and overCardiovascular DiseasesComorbidityDepressionDepressive DisorderDiabetes MellitusEnglandGeneral PracticeHealth Care CostsHumansHEALTH ECONOMICSMENTAL HEALTHPRIMARY CARE

Identifiers

PMID27855101
PMCPMC5073527
OpenAlexW2529547422

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.