Collaborative care for depression and anxiety disorders: results and lessons learned from the Danish cluster-randomized
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RESEARCH ARTICLE
Open Access
Collaborative care for depression and anxiety disorders: results and lessons learned from the Danish clusterrandomized Collabri trials Nadja Kehler Curth1* , Ursula Ødum Brinck-Claussen1, Carsten Hjorthøj1,2, Annette Sofie Davidsen3, John Hagel Mikkelsen4, Marianne Engelbrecht Lau5, Merete Lundsteen6, Claudio Csillag7, Kaj Sparle Christensen8,9, Marie Jakobsen10, Anders Bo Bojesen10, Merete Nordentoft1,11 and Lene Falgaard Eplov1
Abstract Background: Meta-analyses suggest that collaborative care (CC) improves symptoms of depression and anxiety. In CC, a care manager collaborates with a general practitioner (GP) to provide evidence-based care. Most CC research is from the US, focusing on depression. As research results may not transfer to other settings, we developed and tested a Danish CC-model (the Collabri-model) for depression, panic disorder, generalized anxiety disorder, and social anxiety disorder in general practice. Methods: Four cluster-randomized superiority trials evaluated the effects of CC. The overall aim was to explore if CC significantly improved depression and anxiety symptoms compared to treatment-as-usual at 6-months’ followup. The Collabri-model was founded on a multi-professional collaboration between a team of mental-health specialists (psychiatrists and care managers) and GPs. In collaboration with GPs, care managers provided treatment according to a structured plan, including regular reassessments and follow-up. Treatment modalities (cognitive behavioral therapy, psychoeducation, and medication) were offered based on stepped care algorithms. Face-to-face meetings between GPs and care managers took place regularly, and a psychiatrist provided supervision. The control group received treatment-as-usual. Primary outcomes were symptoms of depression (BDI-II) and anxiety (BAI) at 6months’ follow-up. The incremental cost-effectiveness ratio (ICER) was estimated based on 6-months’ follow-up. (Continued on next page)
* Correspondence: [email protected] 1 Copenhagen Research Center for Mental Health – CORE, Mental Health Center Copenhagen, Mental Health Services, Gentofte Hospitalsvej 15, 2900 Hellerup, Denmark Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder
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