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Open Access 01-12-2008 | Study protocol

Multidisciplinary Collaborative Care for Depressive Disorder in the Occupational Health Setting: design of a randomised controlled trial and cost-effectiveness study

Authors: Moniek C Vlasveld, Johannes R Anema, Aartjan TF Beekman, Willem van Mechelen, Rob Hoedeman, Harm WJ van Marwijk, Frans F Rutten, Leona Hakkaart-van Roijen, Christina M van der Feltz-Cornelis

Published in: BMC Health Services Research | Issue 1/2008

Abstract

Background

Major depressive disorder (MDD) has major consequences for both patients and society, particularly in terms of needlessly long sick leave and reduced functioning. Although evidence-based treatments for MDD are available, they show disappointing results when implemented in daily practice. A focus on work is also lacking in the treatment of depressive disorder as well as communication of general practitioners (GPs) and other health care professionals with occupational physicians (OPs). The OP may play a more important role in the recovery of patients with MDD. Purpose of the present study is to tackle these obstacles by applying a collaborative care model, which has proven to be effective in the USA, with a focus on return to work (RTW). From a societal perspective, the (cost)effectiveness of this collaborative care treatment, as a way of transmural care, will be evaluated in depressed patients on sick leave in the occupational health setting.

Methods/Design

A randomised controlled trial in which the treatment of MDD in the occupational health setting will be evaluated in the Netherlands. A transmural collaborative care model, including Problem Solving Treatment (PST), a workplace intervention, antidepressant medication and manual guided self-help will be compared with care as usual (CAU). 126 Patients with MDD on sick leave between 4 and 12 weeks will be included in the study. Care in the intervention group will be provided by a multidisciplinary team of a trained OP-care manager and a consultant psychiatrist. The treatment is separated from the sickness certification. Data will be collected by means of questionnaires at baseline and at 3, 6, 9 and 12 months after baseline. Primary outcome measure is reduction of depressive symptoms, secondary outcome measure is time to RTW, tertiary outcome measure is the cost effectiveness.

Discussion

The high burden of MDD and the high level of sickness absence among people with MDD contribute to the relevance of this study. The intervention is an innovative approach, with trained OPs in a new role as care managers in the treatment of MDD. If this intervention proves to be cost-effective, implementation will be very relevant for individual patients as well as for society.

Trial registration

ISRCTN78462860

Available only for authorised users

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The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1472-6963/8/99/prepub

Title: Multidisciplinary Collaborative Care for Depressive Disorder in the Occupational Health Setting: design of a randomised controlled trial and cost-effectiveness study
Authors: Moniek C Vlasveld
Johannes R Anema
Aartjan TF Beekman
Willem van Mechelen
Rob Hoedeman
Harm WJ van Marwijk
Frans F Rutten
Leona Hakkaart-van Roijen
Christina M van der Feltz-Cornelis
Publication date: 01-12-2008
Publisher: BioMed Central
Published in: BMC Health Services Research / Issue 1/2008
Electronic ISSN: 1472-6963
DOI: https://doi.org/10.1186/1472-6963-8-99

At a glance: The STEP trials

Springer Medicine

Multidisciplinary Collaborative Care for Depressive Disorder in the Occupational Health Setting: design of a randomised controlled trial and cost-effectiveness study

Abstract

Background

Methods/Design

Discussion

Trial registration

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods/Design

Discussion

Trial registration

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