TY - JOUR
T1 - Sustainability of Community-Based Specialized Mental Health Services in Five European Countries
T2 - Protocol for Five Randomized Controlled Trial-Based Health-Economic Evaluations Embedded in the RECOVER-E Program
AU - Wijnen, Ben F. M.
AU - Smit, Filip
AU - Uhernik, Ana Ivicevic
AU - Istvanovic, Ana
AU - Dedovic, Jovo
AU - Dinolova, Roumyana
AU - Nica, Raluca
AU - Velickovski, Robert
AU - Wensing, Michel
AU - Petrea, Ionela
AU - Shields-Zeeman, Laura
N1 - Funding Information:
We would like to thank all associations, institutes, and universities participating in the RECOVER-E project. Specifically, we would like to thank Siret Psychiatric Hospital, GGZ Noord Holland Noord, Mental Health Centre “Prof. N. Shipkoveski” Ltd, Zagreb University Hospital Center, Fundación Mundo Bipolar, European Federation of Psychologists Associations, Croatian Institute of Public Health, National Centre of Public Health and Analyses, Special Psychiatric Hospital Dobrota Kotor, University Clinic Heidelberg, Liga Romana Pentru Sanatate Mintala, European Psychiatric Association, Nicolae Testemi anu State University of Medicine and Pharmacy, Societatea Psihiatrilor, Narcologilor, Psihoterapeutilor si Psihologilor Clinicieni din Republica Moldova, and University Clinic of Psychiatry, Skopje. This project is funded through the European Commission's Horizon 2020 Research Framework program under the Global Alliance for Chronic Diseases program on implementation research for mental disorders in low- and middle-income countries under grant agreement 779362.
Funding Information:
We would like to thank all associations, institutes, and universities participating in the RECOVER-E project. Specifically, we would like to thank Siret Psychiatric Hospital, GGZ Noord Holland Noord, Mental Health Centre “Prof. N. Shipkoveski” Ltd, Zagreb University Hospital Center, Fundación Mundo Bipolar, European Federation of Psychologists Associations, Croatian Institute of Public Health, National Centre of Public Health and Analyses, Special Psychiatric Hospital Dobrota Kotor, University Clinic Heidelberg, Liga Romana Pentru Sanatate Mintala, European Psychiatric Association, Nicolae Testemi anu State University of Medicine and Pharmacy, Societatea Psihiatrilor, Narcologilor, Psihoterapeutilor si Psihologilor Clinicieni din Republica Moldova, and University Clinic of Psychiatry, Skopje. This project is funded through the European Commission’s Horizon 2020 Research Framework program under the Global Alliance for Chronic Diseases program on implementation research for mental disorders in low-and middle-income countries under grant agreement 779362.
Publisher Copyright:
© Ben F M Wijnen, Filip Smit, Ana Ivičević Uhernik, Ana Istvanovic, Jovo Dedovic, Roumyana Dinolova, Raluca Nica, Robert Velickovski, Michel Wensing, Ionela Petrea, Laura Shields-Zeeman. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 01.06.2020. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Research Protocols, is properly cited. The complete bibliographic information, a link to the original publication on http://www.researchprotocols.org, as well as this copyright and license information must be included.
PY - 2020/6
Y1 - 2020/6
N2 - Background: Community-based recovery-oriented mental health services for people with severe mental disorders have not been fully implemented in Bulgaria, Croatia, Macedonia, Montenegro, and Romania. The RECOVER-E project facilitates the implementation of specialized mental health care delivered by setting up services, implementing the services, and evaluating multidisciplinary community mental health teams. The outcomes of the RECOVER-E project are assessed in a trial-based outcome evaluation in each of the participating countries with a health-economic evaluation linked to these trials.Objective: The aim of this protocol paper is to describe the methodology that will be used for the health-economic evaluation alongside the trials.Methods: Implementation sites have been selected in each of the five countries where hospital-based mental health services are available (care as usual [CAU]) for patients with severe mental disorders (severe depression, bipolar disorder, schizophrenia, and other psychotic disorders). The newly implemented health care system will involve community-based recovery-oriented mental health care (CMHC). At each site, 180 consenting patients will be randomized to either CAU or CMHC. Patient-level outcomes are personal and social functioning and quality-adjusted life years (QALYs). Data on participants' health care use will be collected and corresponding health care costs will be computed. This enables evaluation of health care costs of CMHC as compared with CAU, and these costs can be related to patient-level outcomes (functioning and QALY gains) in health-economic evaluation.Results: Data collection was started in December 2018 (Croatia), February 2019 (Montenegro), April 2019 (Romania), June 2019 (North Macedonia), and October 2019 (Bulgaria). The findings of the outcome evaluations will be reported for each of the five countries separately, and the five trials will be pooled for multilevel analysis on a combined dataset.Conclusions: The results of the health-economic evaluation of the RECOVER-E project will contribute to the growing evidence base on the health and economic benefits of recovery-oriented and community-based service models for health systems in transition.
AB - Background: Community-based recovery-oriented mental health services for people with severe mental disorders have not been fully implemented in Bulgaria, Croatia, Macedonia, Montenegro, and Romania. The RECOVER-E project facilitates the implementation of specialized mental health care delivered by setting up services, implementing the services, and evaluating multidisciplinary community mental health teams. The outcomes of the RECOVER-E project are assessed in a trial-based outcome evaluation in each of the participating countries with a health-economic evaluation linked to these trials.Objective: The aim of this protocol paper is to describe the methodology that will be used for the health-economic evaluation alongside the trials.Methods: Implementation sites have been selected in each of the five countries where hospital-based mental health services are available (care as usual [CAU]) for patients with severe mental disorders (severe depression, bipolar disorder, schizophrenia, and other psychotic disorders). The newly implemented health care system will involve community-based recovery-oriented mental health care (CMHC). At each site, 180 consenting patients will be randomized to either CAU or CMHC. Patient-level outcomes are personal and social functioning and quality-adjusted life years (QALYs). Data on participants' health care use will be collected and corresponding health care costs will be computed. This enables evaluation of health care costs of CMHC as compared with CAU, and these costs can be related to patient-level outcomes (functioning and QALY gains) in health-economic evaluation.Results: Data collection was started in December 2018 (Croatia), February 2019 (Montenegro), April 2019 (Romania), June 2019 (North Macedonia), and October 2019 (Bulgaria). The findings of the outcome evaluations will be reported for each of the five countries separately, and the five trials will be pooled for multilevel analysis on a combined dataset.Conclusions: The results of the health-economic evaluation of the RECOVER-E project will contribute to the growing evidence base on the health and economic benefits of recovery-oriented and community-based service models for health systems in transition.
KW - community-based mental health care
KW - cost-effectiveness analysis
KW - cost-utility analysis
KW - economic evaluation
KW - mental health
KW - EQ-5D
KW - COSTS
U2 - 10.2196/17454
DO - 10.2196/17454
M3 - Article
C2 - 32476658
SN - 1929-0748
VL - 9
JO - JMIR Research Protocols
JF - JMIR Research Protocols
IS - 6
M1 - e17454
ER -