Evaluation of a Cross-sectional Coordinated, Severity Stepped, Evidence-based Care Model for Mental Disorders

Summary

This study evaluates a cross sectional, severity stepped, evidence-based care model for patients with mental disorders (RECOVER).

RECOVER is a consortium of well-known institutions for the treatment and integrated care of patients with mental disorders, patient associations, relative associations, research institutions, health care insurances and authorities from the care region Hamburg, Germany.

This project aims to evaluate the RECOVER care model with treatment as usual (TAU) regarding cost-effectiveness (costs, efficiency and cost utility) for patients with mental disorders.

The following questions are examined:

1. Does RECOVER reduce psychiatric health care costs compared to TAU?
2. Does RECOVER improve patient relevant outcomes (i.e. symptom remission, response, daily functioning and quality of life)?
3. Is RECOVER cost effective compared to TAU? (from a payer's and societal perspective)

A total sample of 890 patients with mental disorders will be assessed at baseline (before treatment) and randomized into the RECOVER care model or get TAU. Follow-up assessments are conducted after 6 month and 12 month.

As primary outcomes, cost reduction, improvement in symptoms (i.e. amount of remission and response to treatment, daily functioning and quality of life) and cost-efficiency-ratios will be measured. In addition, several secondary outcome parameters will be assessed.

Impact: The present randomized controlled trial (RCT) evaluates the cross-sectional, severity stepped, evidence-based approach of the RECOVER model in patients with mental disorders. With its focus on effectiveness and cost-effectiveness, the study aims to improve the health care system in Germany.

Conditions

• Delivery of Health Care

Interventions

BEHAVIORAL

RECOVER

For each patient baseline assessment and individual support by a diagnostic and crisis resolution home treatment team is available. In addition, patients will be treated with specific interventions based on their severity grade: Grade 1 (mild): social support, information about mental disorder, e-therapy, consultation, self help, peer-support, supported employment. Grade 2 (medium): psychotherapy (stepped short-term and group therapy), if applicable medical treatment, e-therapy, peer-support, supported employment. Grade 3 (medium to severe): case management, psychotherapy (stepped short-term and group therapy), if applicable medical treatment, e-therapy, peer-support, supported employment. Grade 4 (severe): assertive community treatment, psychotherapy, medical treatment, e-therapy, peer-support, supported employment.

BEHAVIORAL

Treatment as usual

For each patient all common care options within the German health care system are available, depending on the severity grade 1 to 4. This includes the following options: hospital based in-patient, out-patient treatment and day care, community based health care services, general practitioners, private psychiatrists and psychotherapists, self help.

Sponsors & Collaborators

• Federal Ministry of Health, Germany

  collaborator OTHER_GOV

• BARMER

  collaborator OTHER

• AOK Rheinland/Hamburg

  collaborator INDUSTRY

• DAK Gesundheit

  collaborator OTHER

• HEK

  collaborator UNKNOWN

• BKK Linde

  collaborator UNKNOWN

• BKK Mobil Oil

  collaborator INDUSTRY

• BKK Public

  collaborator UNKNOWN

• BKK RWE

  collaborator UNKNOWN

• BKK Salzgitter

  collaborator UNKNOWN

• BKK Technoform

  collaborator UNKNOWN

• BKK VerbundPlus

  collaborator UNKNOWN

• Continentale BKK

  collaborator UNKNOWN

• Heimat BKK

  collaborator UNKNOWN

• Salus BKK

  collaborator UNKNOWN

• TUI BKK

  collaborator UNKNOWN

• WMF Betriebskrankenkasse

  collaborator UNKNOWN

• IKK Classic

  collaborator UNKNOWN

• Energie BKK

  collaborator UNKNOWN

• VIACTIV Krankenkasse

  collaborator UNKNOWN

• Universitätsklinikum Hamburg-Eppendorf

  lead OTHER

Principal Investigators

• Judith Peth, Dr. · University Medical Center Hamburg-Eppendorf, Institute and Outpatients Clinic Medical Psychology

• Holger Schulz, Prof. · University Medical Center Hamburg-Eppendorf, Institute and Outpatients Clinic Medical Psychology

• Hans-Helmut König, Prof. · Institute of Health Economics and Health Care Research

Study Design

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

16 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2018-03-15

Primary Completion

2021-01-28

Completion

2021-01-28

Countries

• Germany

Study Locations