Stepped, evidence-based and integrated care service model vs. usual care for mental disorders: a randomized controlled trial (RECOVER)
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Stepped, evidence-based and integrated care service model vs. usual care for mental disorders: a randomized controlled trial (RECOVER). / Lambert, Martin; König, Hannah; Karow, Anne; König, Hans-Helmut; Rohenkohl, Anja; Luedecke, Daniel; Schröter, Romy; Finter, Constanze; Tlach, Lisa; Schindler, Andreas; Peter, Helmut; Scherer, Martin; Mews, Claudia; Härter, Martin; Bindt, Carola; Löwe, Bernd; Briken, Peer; Peper, Heike; Schweiger, Michael; Mösko, Mike; Bock, Thomas; Deister, Arno; Correll, Christoph U.; Ozga, Ann-Kathrin; Pepić, Amra; Zapf, Antonia; Gallinat, Jürgen; Peth, Judith; Konnopka, Alexander; Schulz, Holger.
In: PSYCHIAT RES, Vol. 339, 09.2024, p. 116007.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Stepped, evidence-based and integrated care service model vs. usual care for mental disorders: a randomized controlled trial (RECOVER)
AU - Lambert, Martin
AU - König, Hannah
AU - Karow, Anne
AU - König, Hans-Helmut
AU - Rohenkohl, Anja
AU - Luedecke, Daniel
AU - Schröter, Romy
AU - Finter, Constanze
AU - Tlach, Lisa
AU - Schindler, Andreas
AU - Peter, Helmut
AU - Scherer, Martin
AU - Mews, Claudia
AU - Härter, Martin
AU - Bindt, Carola
AU - Löwe, Bernd
AU - Briken, Peer
AU - Peper, Heike
AU - Schweiger, Michael
AU - Mösko, Mike
AU - Bock, Thomas
AU - Deister, Arno
AU - Correll, Christoph U.
AU - Ozga, Ann-Kathrin
AU - Pepić, Amra
AU - Zapf, Antonia
AU - Gallinat, Jürgen
AU - Peth, Judith
AU - Konnopka, Alexander
AU - Schulz, Holger
PY - 2024/9
Y1 - 2024/9
N2 - Stepped, evidence-based and integrated care service models have the potential to be used as a reference for mental health services. RECOVER aimed to evaluate cost savings, effectiveness, and cost-effectiveness of such a model within a two arm, assessor- and data analysist-blinded RCT in Hamburg, Germany. Participants aged 16-79 years with mental disorders were randomly assigned either to RECOVER or treatment as usual (TAU). Primary outcomes comprised costs, effectiveness (combined symptoms, functioning, quality of life), and cost-effectiveness, hierarchically ordered. Outcomes were evaluated according to the ITT principle, group differences regarding costs with adjusted generalized linear models, effectiveness with ANCOVA models, and cost-effectiveness with the incremental cost-effectiveness ratio (ICER) and cost-effectiveness acceptability curves (CEACs). Between 1/1/2018 and 12/31/2020, n = 891 were finally included (n = 477 in RECOVER, n = 444 in TAU). RECOVER was associated with significantly lower annual total costs (-22 %), health and social care costs (-25 %) and hospital costs (-50 %). Effectiveness analyses showed a significantly better outcome for RECOVER with the fully imputed data . The CEACs descriptively demonstrated that RECOVER was cost-effective with a probability of >95 %. Treatment in RECOVER resulted in substantial cost reductions with better cost-effectiveness. RECOVER can be recommended as a reference model for comprehensive and integrated mental health services.
AB - Stepped, evidence-based and integrated care service models have the potential to be used as a reference for mental health services. RECOVER aimed to evaluate cost savings, effectiveness, and cost-effectiveness of such a model within a two arm, assessor- and data analysist-blinded RCT in Hamburg, Germany. Participants aged 16-79 years with mental disorders were randomly assigned either to RECOVER or treatment as usual (TAU). Primary outcomes comprised costs, effectiveness (combined symptoms, functioning, quality of life), and cost-effectiveness, hierarchically ordered. Outcomes were evaluated according to the ITT principle, group differences regarding costs with adjusted generalized linear models, effectiveness with ANCOVA models, and cost-effectiveness with the incremental cost-effectiveness ratio (ICER) and cost-effectiveness acceptability curves (CEACs). Between 1/1/2018 and 12/31/2020, n = 891 were finally included (n = 477 in RECOVER, n = 444 in TAU). RECOVER was associated with significantly lower annual total costs (-22 %), health and social care costs (-25 %) and hospital costs (-50 %). Effectiveness analyses showed a significantly better outcome for RECOVER with the fully imputed data . The CEACs descriptively demonstrated that RECOVER was cost-effective with a probability of >95 %. Treatment in RECOVER resulted in substantial cost reductions with better cost-effectiveness. RECOVER can be recommended as a reference model for comprehensive and integrated mental health services.
KW - Community mental health service
KW - stepped care
KW - coordinated care
KW - mental disorders
KW - severe mental illness
KW - e-mental-health
U2 - 10.1016/j.psychres.2024.116007
DO - 10.1016/j.psychres.2024.116007
M3 - SCORING: Journal article
C2 - 38865905
VL - 339
SP - 116007
JO - PSYCHIAT RES
JF - PSYCHIAT RES
SN - 0165-1781
ER -