{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T11:39:57Z","timestamp":1782819597897,"version":"3.54.5"},"reference-count":46,"publisher":"BMJ","issue":"10","funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2016,8,9]]},"published-print":{"date-parts":[[2016,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To 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).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>36 primary care general practices in North West England.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>387 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 \u226518\u2005years, 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention<\/jats:title>\n                    <jats:p>Collaborative care consisted of evidence-based low-intensity psychological treatments, delivered over 3\u2005months and case management by a practice nurse and a Psychological Well Being Practitioner.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures<\/jats:title>\n                    <jats:p>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\u2005months).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The mean cost per participant of collaborative care was \u00a3317 (95% CI 284 to 350). Over 24\u2005months, it was estimated that collaborative care was associated with greater healthcare usage costs (net cost \u00a3674 (95% CI \u221230\u2005953 to 38\u2005853)) and QALYs (net QALY gain 0.04 (95% CI \u22120.46 to 0.54)) than usual care, resulting in a cost per QALY gained of \u00a316\u2005123, and a likelihood of being cost-effective of 0.54 (willingness to pay threshold of \u00a320\u2005000).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Collaborative 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/www.isrctn.com\/ISRCTN80309252\" ext-link-type=\"uri\">ISRCTN80309252<\/jats:ext-link>\n                      ; Post-results.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2016-012514","type":"journal-article","created":{"date-parts":[[2016,10,7]],"date-time":"2016-10-07T23:09:04Z","timestamp":1475881744000},"page":"e012514","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":42,"title":["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"],"prefix":"10.1136","volume":"6","author":[{"given":"Elizabeth M","family":"Camacho","sequence":"first","affiliation":[{"name":"Manchester Centre for Health Economics, University of Manchester, Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dionysios","family":"Ntais","sequence":"additional","affiliation":[{"name":"Manchester Centre for Health Economics, University of Manchester, Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Coventry","sequence":"additional","affiliation":[{"name":"Mental Health and Addiction Research Group, University of York, York, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Bower","sequence":"additional","affiliation":[{"name":"Centre for Primary Care, University of Manchester, Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karina","family":"Lovell","sequence":"additional","affiliation":[{"name":"The School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolyn","family":"Chew-Graham","sequence":"additional","affiliation":[{"name":"Primary Care & Health Sciences, University of Keele, Staffordshire, UK"},{"name":"Centre for Primary Care, University of Manchester, Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clare","family":"Baguley","sequence":"additional","affiliation":[{"name":"NHS Health Education North West, Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Gask","sequence":"additional","affiliation":[{"name":"Centre for Primary Care, University of Manchester, Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Dickens","sequence":"additional","affiliation":[{"name":"Mental Health Research Group, University of Exeter, Exeter, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda M","family":"Davies","sequence":"additional","affiliation":[{"name":"Manchester Centre for Health Economics, University of Manchester, Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2016,10,7]]},"reference":[{"key":"2025121400490173000_6.10.e012514.1","unstructured":"McManus S , Meltzer H , Brugha TS , et al . 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