Link-me: Protocol for a randomised controlled trial of a systematic approach to stepped mental health care in primary care

Fletcher, Susan; Chondros, Patty; Palmer, Victoria; Chatterton, Mary Lou; Spittal, Matthew J; Mihalopoulos, Cathrine; Wood, Anna; Harris, Meredith; Burgess, Philip; Bassilios, Bridget; Pirkis, Jane; Gunn, Jane

doi:10.1016/j.cct.2018.12.014

Cited by 4 publications

(16 citation statements)

References 51 publications

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“…The difference in mean QALYs between trial arms was estimated using a GLM with the Gaussian family and identity link. All regression and GLM models were estimated with and without adjustment for several baseline covariates specified a priori (prognostic group and baseline K10 score) [5,16]. Pre-specified subgroup analyses were conducted across prognostic groups.…”

Section: Discussionmentioning

confidence: 99%

“…PHNs are not-for-profit companies commissioning health services in 31 geographically defined areas throughout Australia [6]. The study protocol and analysis plan for clinical and economic outcomes are described in full elsewhere [4,5].…”

Section: Methodsmentioning

confidence: 99%

“…[4] Same as [3] but adjusted for general practice. [5] Sensitivity analysis where care navigators spent 50% of time on care navigation. Data was multiply imputed prior to analysis.…”

Section: Health Outcomesmentioning

confidence: 99%

“…In a pragmatic, stratified randomised controlled trial (RCT), the Link-me intervention resulted in greater reductions in psychological distress at six months over usual care [4]. This paper reports on the economic evaluation incorporated in the RCT [5].…”

Section: Introductionmentioning

confidence: 99%

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Economic evaluation of a Decision Support Tool to guide intensity of mental health care in general practice: the Link-me pragmatic randomised controlled trial

et al. 2022

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Background: This paper reports on the cost-effectiveness evaluation of Link-me -a digitally supported, systematic approach to triaging care for depression and anxiety in primary care that uses a patient-completed Decision Support Tool (DST). Methods:The economic evaluation was conducted alongside a parallel, stratified individually randomised controlled trial (RCT) comparing prognosis-matched care to usual care at six-and 12-month follow-up. Twenty-three general practices in three Australian Primary Health Networks recruited 1,671 adults (aged 18 -75 years), predicted by the DST to have minimal/mild or severe depressive or anxiety symptoms in three months. The minimal/mild prognostic group was referred to low intensity services. Participants screened in the severe prognostic group were offered high intensity care navigation, a model of care coordination. The outcome measures included in this evaluation were health sector costs (including development and delivery of the DST, care navigation and other healthcare services used) and societal costs (health sector costs plus lost productivity), psychological distress [Kessler Psychological Distress Scale (K10)] and quality adjusted life years (QALYs) derived from the EuroQol 5-dimension quality of life questionnaire with Australian general population preference weights applied.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

“…[4] Same as [3] but adjusted for general practice. [5] Sensitivity analysis where care navigators spent 50% of time on care navigation. Data was multiply imputed prior to analysis.…”

Section: Health Outcomesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Economic evaluation of a Decision Support Tool to guide intensity of mental health care in general practice: the Link-me pragmatic randomised controlled trial

et al. 2022

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“…Efficient triage processes improve appointment attendance rates (31) and reduce the negative effect of wait times, including loss of motivation and lowered expectation of improving (32). Furthermore, accurate triage matches appropriate level of care to the individual's needs and manages demand by reserving more intense treatment for clients with greater need (33).…”

Section: Standardised and Ongoing Multidimensional Online Assessmentmentioning

confidence: 99%

Using Digital Technologies to Facilitate Care Coordination Between Youth Mental Health Services: A Guide for Implementation

et al. 2021

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Enhanced care coordination is essential to improving access to and navigation between youth mental health services. By facilitating better communication and coordination within and between youth mental health services, the goal is to guide young people quickly to the level of care they need and reduce instances of those receiving inappropriate care (too much or too little), or no care at all. Yet, it is often unclear how this goal can be achieved in a scalable way in local regions. We recommend using technology-enabled care coordination to facilitate streamlined transitions for young people across primary, secondary, more specialised or hospital-based care. First, we describe how technology-enabled care coordination could be achieved through two fundamental shifts in current service provisions; a model of care which puts the person at the centre of their care; and a technology infrastructure that facilitates this model. Second, we detail how dynamic simulation modelling can be used to rapidly test the operational features of implementation and the likely impacts of technology-enabled care coordination in a local service environment. Combined with traditional implementation research, dynamic simulation modelling can facilitate the transformation of real-world services. This work demonstrates the benefits of creating a smart health service infrastructure with embedded dynamic simulation modelling to improve operational efficiency and clinical outcomes through participatory and data driven health service planning.

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Clinical efficacy of a Decision Support Tool (Link-me) to guide intensity of mental health care in primary practice: a pragmatic stratified randomised controlled trial

Fletcher

Spittal

Chondros

et al. 2021

The Lancet Psychiatry

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Link-me: Protocol for a randomised controlled trial of a systematic approach to stepped mental health care in primary care

Abstract: Link-me: Protocol for a randomised controlled trial of a systematic approach to stepped mental health care in primary care. Concli (2018),

Cited by 4 publications

References 51 publications

Economic evaluation of a Decision Support Tool to guide intensity of mental health care in general practice: the Link-me pragmatic randomised controlled trial

Economic evaluation of a Decision Support Tool to guide intensity of mental health care in general practice: the Link-me pragmatic randomised controlled trial

Using Digital Technologies to Facilitate Care Coordination Between Youth Mental Health Services: A Guide for Implementation

Clinical efficacy of a Decision Support Tool (Link-me) to guide intensity of mental health care in primary practice: a pragmatic stratified randomised controlled trial

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