Does liaison psychiatry improve the cost-effectiveness of health care delivery to depressed elderly medical in-patients? A randomised controlled trial and cost-effectiveness analysis
| ISRCTN | ISRCTN46437760 |
|---|---|
| DOI | https://doi.org/10.1186/ISRCTN46437760 |
| Secondary identifying numbers | Cullum HSR/0301 |
- Submission date
- 23/01/2004
- Registration date
- 23/01/2004
- Last edited
- 21/12/2009
- Recruitment status
- No longer recruiting
- Overall study status
- Completed
- Condition category
- Mental and Behavioural Disorders
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data
Plain English summary of protocol
Not provided at time of registration
Contact information
Dr Sarah Cullum
Scientific
Scientific
University of Cambridge
Institute of Public Health
Forvie Site
Robinson Way
Cambridge
CB2 2SR
United Kingdom
| Phone | +44 (0)1223 330322 |
|---|
Study information
| Study design | Randomised controlled trial |
|---|---|
| Primary study design | Interventional |
| Secondary study design | Randomised controlled trial |
| Study setting(s) | Hospital |
| Study type | Other |
| Scientific title | |
| Study objectives | Aims of the study: 1. To evaluate the effect of a 'liaison' model of care (screening, plus assessment and co-ordination of management of depressive disorder by a specialist psychiatric nurse) on the health outcomes of elderly medical inpatients. 2. To evaluate the cost-effectiveness of the intervention from the viewpoint of health and social services, and patients and their carers. Hypotheses: Compared to standard care, after 16 weeks, the 'liaison' model of care will: 1. Increase the number of patients that recover from depression 2. Increase patients' quality of life 3. Increase patients' satisfaction with the service 4. Reduce carer burden 5. Increase the cost-effectiveness ratios for the health benefits (resolution of depression, change in depression rating and quality of life score per cost of resources used). |
| Ethics approval(s) | Not provided at time of registration |
| Health condition(s) or problem(s) studied | Depression, anxiety, neuroses |
| Intervention | 1. A visit by a specialist nurse within the first week of admission (intervention arm) 2. Put on a waiting list to see a member of the research team at home (control arm) |
| Intervention type | Other |
| Primary outcome measure | Resolution of ICD10 depression and change in depression rating measured by the Montgomery-Asberg Depression Rating Scale (MADRS) at 16 weeks after the initial assessment compared between intervention and comparison groups, adjusted for severity of disability at baseline. |
| Secondary outcome measures | Change in quality of life score (EuroQOL), difference in patient satisfaction (adapted version of patients' satisfaction with stroke services questionnaire), change in carer burden (Caregiver Strain Index and GHQ-12) at 16 weeks after the initial assessment, compared between intervention and comparison groups. (References for standardised measures given in attached research proposal.) Cost-effectiveness ratios for the health benefits resolution of depression, change in depression and quality of life scores) compared to the resource costs in each arm of the study will be calculated. Resources consumed in secondary care (costs of index admission, subsequent inpatient stay and outpatient contact), primary care (GP consultations, contact with nursing staff including specialist psychiatric nurse), and number of hours care from social services will be calculated from routine data sources including hospital information systems, GP and medical records and social services information systems. The economic impact of the intervention upon patients and their carers will also be evaluated. |
| Overall study start date | 01/01/2002 |
| Completion date | 01/01/2004 |
Eligibility
| Participant type(s) | Patient |
|---|---|
| Age group | Senior |
| Sex | Both |
| Target number of participants | 138 (added 18/12/09) |
| Key inclusion criteria | Patients aged 65 years or over, admitted to general medical wards of a district general hospital (West Suffolk Hospital) with a stay over 5 days, over a period of 15 months (January 2002 to March 2003). |
| Key exclusion criteria | 1. Unable to give informed consent to enter the study due to moderate/severe dementia or other reasons 2. No spoken English 3. Dependent upon alcohol or other psychotropic drugs 4. Due to be transferred or discharged on the day of the initial assessment 5. Too physically ill or too confused to be interviewed |
| Date of first enrolment | 01/01/2002 |
| Date of final enrolment | 01/01/2004 |
Locations
Countries of recruitment
- England
- United Kingdom
Study participating centre
University of Cambridge
Cambridge
CB2 2SR
United Kingdom
CB2 2SR
United Kingdom
Sponsor information
NHS R&D Regional Programme Register - Department of Health (UK)
Government
Government
The Department of Health
Richmond House
79 Whitehall
London
SW1A 2NL
United Kingdom
| Phone | +44 (0)20 7307 2622 |
|---|---|
| dhmail@doh.gsi.org.uk | |
| Website | http://www.doh.gov.uk |
Funders
Funder type
Government
NHS Executive Eastern (UK)
No information available
Results and Publications
| Intention to publish date | |
|---|---|
| Individual participant data (IPD) Intention to share | No |
| IPD sharing plan summary | Not provided at time of registration |
| Publication and dissemination plan | Not provided at time of registration |
| IPD sharing plan |
Study outputs
| Output type | Details | Date created | Date added | Peer reviewed? | Patient-facing? |
|---|---|---|---|---|---|
| Results article | results | 01/07/2007 | Yes | No |
