Generalised anxiety disorder panic disorder
Conditions
Interventions
*Intervention(s): Evidence exists for effectiveness of stepped care in PD and
GAD,(68) more specific for
two of the three proposed steps. The effect size of the combined step 2 and
three ranged betw
Sponsors
Zorgonderzoek Nederland (ZON)
Eligibility
Age
18 Years to 99 Years
Inclusion criteria
Inclusion criteria: Patients who visit the GP practice and meet the DSM-IV diagnosis for GAD or PD are included in the study.
Exclusion criteria
Exclusion criteria: Suicidal, psychotic, cognitive deterioration.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| *outcome parameters: Baseline measurememts: The mini-International Neuropsychiatric Interview (MINI 28;29) is administered for the classification of symptoms and the BAI for measurement of severity. Primary outcome measure is reduction of GAD or PD symptoms as measured by the BAI. Secondary outcome measures are remittance of GAD or PD as measured with MINI and the BAI (score below 10; range 0-61), adherence and compliance, and the Patient-Doctor Relationship Questionnaire (PDRQ-9). The number and intensity of functional somatic complaints a patient is experiencing is assessed with the LKV (Lichamelijke Klachten Vragenlijst),(33) the Somatosensory amplification Scale(34) and the Whitely Index.(35) Health care use is assessed by the Scale for Medical Utilisation of Health Services. | — |
Secondary
| Measure | Time frame |
|---|---|
| *Economic evaluation: The aim of this economic evaluation is to assess the cost effectiveness of collaborative stepped care in primary care of the treatment of GAD/PD. The results will be expressed as cost per unit of the BAI and as cost per Quality Adjusted Life Year (QALY). The economic evaluation will be undertaken from a societal perspective. Hence, all relevant effects and costs due to resource utilisation within the healthcare (direct medical costs) and costs due to production losses (productivity costs) will be included. The costs will be estimated in line with the Dutch guidelines for cost calculations in health care.(38)The TiC-P will be used for collecting data on health care utilisation as well as production losses.(36,37). The TiC-P is commonly applied in economic evaluations of treatments in mental health care. For instance, the TiC-P was recently used in a large naturalistic trial on the cost-utility of brief psychological treatment for depression and anxiety.(69) Furthermore, we will add a module of the Prodisq, a questionnaire for collecting data on production losses of paid work. Calculating the total direct medical costs, the total number of medical contacts (GP visits, outpatient visits, use of medication, etc.) will be multiplied by unit costs of the corresponding health care services. Reference unit prices of the corresponding health care services will be applied, and adjusted to the year of the study according to the consumer price index.(38) Since the collaborative stepped care model is new kind of intervention, a unit price per session is currently not available. To determine a reference price for this intervention, a micro-costing study will be performed. Therefore, we will perform measurements of time for face-to-face contacts with the patient as well as indirect time per contact. Indirect time per contact may consist of e.g. mutual consultations contacts between GP, casemanager and/or psychiatrist. Fur | — |
Countries
Netherlands
Outcome results
None listed