Evidence map›Paper›PMID 36109694›Full record

Trial reportBMC primary care2022

Economic evaluation of a Decision Support Tool to guide intensity of mental health care in general practice: the Link-me pragmatic randomised controlled trial.

Mary Lou Chatterton, Meredith Harris, Philip Burgess, Susan Fletcher, Matthew J Spittal, Jan Faller, Victoria J Palmer, Patty Chondros, Bridget Bassilios, Jane Pirkis and 2 more

Open access · goldAbstract readRandomized Controlled TrialPragmatic Clinical Trial
In one paragraph

Trial report in BMC primary care, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.1field-weighted citation impact, top 14% 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

2 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. 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

12 authors at 4 institutions in 1 country.

Mary Lou ChattertonSchool of Public Health and Preventive Medicine, Monash University, Level 4, 553 St Kilda Road, Melbourne, VIC, 3004, Australia. m.chatterton@monash.edu.
Meredith HarrisSchool of Public Health, The University of Queensland, Brisbane, Australia.
Philip BurgessSchool of Public Health, The University of Queensland, Brisbane, Australia.
Susan FletcherDepartment of General Practice, Melbourne Medical School, The University of Melbourne, Melbourne, Australia.
Matthew J SpittalMelbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia.
Jan FallerSchool of Public Health and Preventive Medicine, Monash University, Level 4, 553 St Kilda Road, Melbourne, VIC, 3004, Australia.
Victoria J PalmerThe ALIVE National Centre for Mental Health Research Translation, The University of Melbourne, Melbourne, Australia.
Patty ChondrosThe ALIVE National Centre for Mental Health Research Translation, The University of Melbourne, Melbourne, Australia.
Bridget BassiliosMelbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia.
Jane PirkisThe ALIVE National Centre for Mental Health Research Translation, The University of Melbourne, Melbourne, Australia.
Jane GunnThe ALIVE National Centre for Mental Health Research Translation, The University of Melbourne, Melbourne, Australia.
Cathrine MihalopoulosSchool of Public Health and Preventive Medicine, Monash University, Level 4, 553 St Kilda Road, Melbourne, VIC, 3004, Australia.
The University of Melbourne · AUDeakin University · AUThe University of Queensland · AUMonash University · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThis paper reports on the cost-effectiveness evaluation of Link-me - a digitally supported, systematic approach to triaging care for depression and anxiety in primary care that uses a patient-completed Decision Support Tool (DST).

methodsThe economic evaluation was conducted alongside a parallel, stratified individually randomised controlled trial (RCT) comparing prognosis-matched care to usual care at six- and 12-month follow-up. Twenty-three general practices in three Australian Primary Health Networks recruited 1,671 adults (aged 18 - 75 years), predicted by the DST to have minimal/mild or severe depressive or anxiety symptoms in three months. The minimal/mild prognostic group was referred to low intensity services. Participants screened in the severe prognostic group were offered high intensity care navigation, a model of care coordination. The outcome measures included in this evaluation were health sector costs (including development and delivery of the DST, care navigation and other healthcare services used) and societal costs (health sector costs plus lost productivity), psychological distress [Kessler Psychological Distress Scale (K10)] and quality adjusted life years (QALYs) derived from the EuroQol 5-dimension quality of life questionnaire with Australian general population preference weights applied. Costs were valued in 2018-19 Australian dollars (A$).

resultsAcross all participants, the health sector incremental cost-effectiveness ratio (ICER) of Link-me per point decrease in K10 at six months was estimated at $1,082 (95% CI $391 to $6,204) increasing to $2,371 (95% CI $191 to Dominated) at 12 months. From a societal perspective, the ICER was estimated at $1,257/K10 point decrease (95% CI Dominant to Dominated) at six months, decreasing to $1,217 (95% CI Dominant to Dominated) at 12 months. No significant differences in QALYs were detected between trial arms and the intervention was dominated (less effective, more costly) based on the cost/QALY ICER.

conclusionsThe Link-me approach to stepped mental health care would not be considered cost-effective utilising a cost/QALY outcome metric commonly adopted by health technology assessment agencies. Rather, Link-me showed a trend toward cost-effectiveness by providing improvement in mental health symptoms, measured by the K10, at an additional cost.

trial registrationAustralian and New Zealand Clinical Trials Registry, ANZCTRN 12617001333303.

Indexed as

General PracticeMental HealthAdultAustraliaCost-Benefit AnalysisHumansQuality-Adjusted Life YearsCare navigationCost-effectivenessEconomic evaluationMental healthPrimary CareRandomised controlled trial

Identifiers

PMID36109694
PMCPMC9479277
OpenAlexW4296027775

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.