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Collaborative care improved the cost effectiveness of treatment for major depression in primary care

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Question What are the treatment costs, cost offset effects, and cost effectiveness of collaborative care of depression in primary care?

Design

Cost analysis using data from 2 randomised controlled trials each with 12 months follow up.

Setting

Group Health Cooperative of Puget Sound, Seattle, Washington, USA.

Patients

370 patients between 18 and 80 years of age who were starting antidepressant medication for definite or probable major depression as diagnosed by their primary care physician. Exclusion criteria were current alcohol abuse, psychotic symptoms, or dementia; pregnancy; or terminal illness. Follow up and cost data were available for 332 patients (90%).

Intervention

Patients were allocated to collaborative care or usual care. Collaborative care consisted of psychiatrist delivered enhanced management of pharmacotherapy and brief psychoeducational interventions to enhance adherence (trial 1) or brief …

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