Cost effectiveness of interpersonal community psychiatric treatment for people with long-term severe non-psychotic mental disorders: protocol of a multi-centre randomized controlled trial.
BACKGROUND
This study aims for health gain and cost reduction in the care for people with long-term non-psychotic psychiatric disorders. Present care for this population has a limited evidence base, is often open ended, little effective, and expensive. Recent epidemiological data shows that 43.5% of the Dutch are affected by mental illness during their life. About 80% of all patients receiving mental health services (MHS) have one or more non-psychotic disorders. Particularly for this group, long-term treatment and care is poorly developed. Care As Usual (CAU) currently is a form of low-structured treatment/care. Interpersonal Community Psychiatric Treatment (ICPT) is a structured treatment for people with long-term, non-psychotic disorders, developed together with patients, professionals, and experts. ICPT uses a number of evidence-based techniques and was positively evaluated in a controlled pilot study.


METHODS
Multi-centre cluster-randomized clinical trial: 36 professionals will be randomly allocated to either ICPT or CAU for an intervention period of 12 months, and a follow-up of 6 months. 180 Patients between 18-65 years of age will be included, who have been diagnosed with a non-psychotic psychiatric disorder (depressive, anxiety, personality or substance abuse disorder), have long-term (>2 years) or high care use (>1 outpatient contact per week or >2 crisis contacts per year or >1 inpatient admission per year), and who receive treatment in a specialized mental health care setting. The primary outcome variable is quality of life; secondary outcomes are costs, recovery, general mental health, therapeutic alliance, professional-perceived difficulty of patient, care needs and social contacts.


CONCLUSIONS
No RCT, nor cost-effectiveness study, has been conducted on ICPT so far. The empirical base for current CAU is weak, if not absent. This study will fill this void, and generate data needed to improve daily mental health care.


BACKGROUND
Netherlands Trial Register (NTR): 3988 . Registered 13th of May 2013.
Research Group Social Psychiatry & Mental Health Nursing, University of Applied Sciences Arnhem Nijmegen, PO Box 6960, Nijmegen, GL, 6503, The Netherlands. mark.vanveen@han.nl.|Altrecht Mental Health Services, Oude Arnhemseweg 260, Zeist, BK, 3705, The Netherlands. mark.vanveen@han.nl.
Mark
M
van Veen
Research Group Social Psychiatry & Mental Health Nursing, University of Applied Sciences Arnhem Nijmegen, PO Box 6960, Nijmegen, GL, 6503, The Netherlands. bauke.koekkoek@han.nl.|Pro Persona Mental Health Services, Wolfheze 2 ProCES, Renkum, BE, 6874, The Netherlands. bauke.koekkoek@han.nl.
Bauke
B
Koekkoek
Department of Psychiatry, Erasmus MC, University Medical Center, PO Box 2040, Rotterdam, CA, 3000, The Netherlands. niels.clmulder@wxs.nl.
Niels
N
Mulder
Department of Research and Development, GGZ Oost Brabant Mental Health Services, PO Box 3, Boekel, ZG, 5427, The Netherlands. D.Postulart@ggzoostbrabant.nl.
Debby
D
Postulart
Epidemiology, Biostatistics & Health Technology Assessment, Radboud University Medical Center, Geert Grooteplein Zuid 10, Nijmegen, GA, 6525, The Netherlands. Eddy.Adang@radboudumc.nl.
Eddy
E
Adang
Epidemiology, Biostatistics & Health Technology Assessment, Radboud University Medical Center, Geert Grooteplein Zuid 10, Nijmegen, GA, 6525, The Netherlands. Steven.Teerenstra@radboudumc.nl.
Steven
S
Teerenstra
Scientific Institute for Quality of Healthcare, Radboud University Medical Center Nursing science, PO Box 9101, Nijmegen, HB, 6500, The Netherlands. Lisette.Schoonhoven@radboudumc.nl.|Faculty of Health Sciences Highfield, Southampton, University of Southampton, SO17 1BJ, Southampton, UK. Lisette.Schoonhoven@radboudumc.nl.
Lisette
L
Schoonhoven
Centre for Health Services and Nursing Research, Kapucijnenvoer 35 blok d, box 7001, 3000, Leuven, Belgium. Theo.vanachterberg@med.kuleuven.be.
Theo
T
van Achterberg
D000293:Adolescent; D000328:Adult; D000368:Aged; D002985:Clinical Protocols; D003153:Community Health Services / Q000191:economics*; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000191:economics / Q000523:psychology / Q000628:therapy*; D008605:Mental Health Services / Q000191:economics*; D008875:Middle Aged; D010865:Pilot Projects; D011613:Psychotherapy / Q000191:economics*; D011788:Quality of Life; D055815:Young Adult