{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T01:01:09Z","timestamp":1781571669346,"version":"3.54.5"},"reference-count":56,"publisher":"Cambridge University Press (CUP)","issue":"9","license":[{"start":{"date-parts":[[2011,12,13]],"date-time":"2011-12-13T00:00:00Z","timestamp":1323734400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Psychol. Med."],"published-print":{"date-parts":[[2012,9]]},"abstract":"<jats:sec id=\"S0033291711002893_sec_a001\"><jats:title>Background<\/jats:title><jats:p>Improving the quality of mental health care requires integrating successful research interventions into \u2018real-world\u2019 practice settings. Coordinated Anxiety Learning and Management (CALM) is a treatment-delivery model for anxiety disorders encountered in primary care. CALM offers cognitive behavioral therapy (CBT), medication, or both; non-expert care managers assisting primary care clinicians with adherence promotion and medication optimization; computer-assisted CBT delivery; and outcome monitoring. This study describes incremental benefits, costs and net benefits of CALM <jats:italic>versus<\/jats:italic> usual care (UC).<\/jats:p><\/jats:sec><jats:sec id=\"S0033291711002893_sec_a002\"><jats:title>Method<\/jats:title><jats:p>The CALM randomized, controlled effectiveness trial was conducted in 17 primary care clinics in four US cities from 2006 to 2009. Of 1062 eligible patients, 1004 English- or Spanish-speaking patients aged 18\u201375 years with panic disorder (PD), generalized anxiety disorder (GAD), social anxiety disorder (SAD) and\/or post-traumatic stress disorder (PTSD) with or without major depression were randomized. Anxiety-free days (AFDs), quality-adjusted life years (QALYs) and expenditures for out-patient visits, emergency room (ER) visits, in-patient stays and psychiatric medications were estimated based on blinded telephone assessments at baseline, 6, 12 and 18 months.<\/jats:p><\/jats:sec><jats:sec id=\"S0033291711002893_sec_a003\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>Over 18 months, CALM participants, on average, experienced 57.1 more AFDs [95% confidence interval (CI) 31\u201383] and $245 additional medical expenses (95% CI $\u2013733 to $1223). The mean incremental net benefit (INB) of CALM <jats:italic>versus<\/jats:italic> UC was positive when an AFD was valued \u2a7e$4. For QALYs based on the Short-Form Health Survey-12 (SF-12) and the EuroQol EQ-5D, the mean INB was positive at \u2a7e$5000.<\/jats:p><\/jats:sec><jats:sec id=\"S0033291711002893_sec_a004\" sec-type=\"conclusion\"><jats:title>Conclusions<\/jats:title><jats:p>Compared with UC, CALM provides significant benefits with modest increases in health-care expenditures.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s0033291711002893","type":"journal-article","created":{"date-parts":[[2011,12,13]],"date-time":"2011-12-13T16:48:17Z","timestamp":1323794897000},"page":"1937-1948","source":"Crossref","is-referenced-by-count":23,"title":["Incremental benefits and cost of coordinated anxiety learning and management for anxiety treatment in primary care"],"prefix":"10.1017","volume":"42","author":[{"given":"J. M.","family":"Joesch","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. 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