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Review: enhanced primary care programmes are effective for people with depression but are associated with increased healthcare costs

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 Q Are enhanced care programmes cost effective for improving the quality of care and outcome in primary care settings for people with depression?

METHODS

Embedded ImageDesign:

Systematic review.

Embedded ImageData sources:

PsycLIT, EconLIT, Medline, EMBASE, CINAHL, NHS Economic Evaluation Database, Health Economics Evaluation Database, Database of Abstracts and Reviews of Effects, and the Cochrane Library searched November 2005. Reference lists were hand searched and authors contacted for unpublished data.

Embedded ImageStudy selection and analysis:

Eligible studies were randomised controlled trials (RCTs) of enhanced primary care programmes for people with depression including cost effectiveness, cost–benefit, cost minimisation, or cost–utility analyses. Enhanced care programmes included: clinician education, dissemination and implementation of treatment or management guidelines, reconfiguration of primary care roles, active follow-up or case management, and interventions to improve working relationships between primary care and other health services. Exclusions: RCTs of psychotherapy or drug treatment only. Data were extracted on intervention, design, clinical outcome and economic evaluation. Costs were converted to US dollars or UK pounds (year not reported). Nixon’s schematic method of data synthesis was used to represent …

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