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The British Journal of Psychiatry
Year: 2009  |  Volume: 195  |  Issue: 4  |  Page No.: 308 - 317

Cost-effectiveness of a primary care model for anxiety disorders

H. H Konig, A Born, D Heider, H Matschinger, S Heinrich, S. G Riedel Heller, D Surall, M. C Angermeyer and C. Roick    

Abstract:

Background

Individuals with anxiety disorders often do not receive an accurate diagnosis or adequate treatment in primary care.

Aims

To analyse the cost-effectiveness of an optimised care model for people with anxiety disorders in primary care.

Method

In a cluster randomised controlled trial, 46 primary care practices with 389 individuals positively screened with anxiety were randomised to intervention (23 practices, 201 participants) or usual care (23 practices, 188 participants). Physicians in the intervention group received training on diagnosis and treatment of anxiety disorders combined with the offer of a psychiatric consultation–liaison service for 6 months. Anxiety, depression, quality of life, service utilisation and costs were assessed at baseline, 6-month and 9-month follow-up.

Results

No significant differences were observed between intervention and control group on the Beck Anxiety Inventory, Beck Depression Inventory and EQ–5D during follow-up. Total costs were higher in the intervention group (4911 v. 3453, P = 0.09). The probability of an incremental cost-effectiveness ratio <50 000 per quality-adjusted life year was below 10%.

Conclusions

The optimised care model did not prove to be cost-effective.

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