Cost-Effectiveness of IMPRovE: A Multicomponent Intervention to Increase Adherence to Guideline Recommendations for the Diagnosis and Management of Work-Related Mental Health Conditions in General Practice.

PURPOSE: To evaluate the cost and cost-effectiveness of a multicomponent intervention to increase general practitioners' (GPs) adherence to guideline recommendations for diagnosis and management of work-related mental health conditions (the Guideline).

METHODS

Economic evaluation from Australian health system and societal perspectives based on data from a pragmatic hybrid III parallel cluster randomised controlled trial (IMPRovE) that ran from December 2020 to December 2022.

RESULTS

The IMPRovE intervention generated a statistically significant improvement in GP adherence scores of 0.98 on 0 to 9 scale (95%CI: 0.38 to 1.58). We found no evidence for a significant between-group difference in total quality-adjusted life days (QALDs) per patient to trial-end (adjusted mean difference: -1.9, 95%CI: -24.2 to 20.3), productivity gains per patient to trial-end (adjusted mean difference: $5,818, 95%CI: -$12,346 to $23,982), or total health sector costs per patient to trial-end (adjusted mean difference: -$2,703, 95%CI: -$6,025 to $620). Under conservative assumptions, we find a significant between-group difference in total health sector cost per GP (adjusted mean difference: -$14,278, 95%CI: -$21,358, -$7,198). For improving GP adherence to the Guideline, we can be 95% confident that the IMPRovE intervention is more cost-effective than waitlist control from a health system perspective (when we set aside productivity gains). This remains the case even when improvements in GP adherence carry zero value.

CONCLUSION

The IMPRovE intervention is likely to be more cost-effective than waitlist control for increasing GP adherence to Guideline recommendations. We were unable to draw strong conclusions regarding the cost-effectiveness of the IMPRovE intervention for improving patient outcomes.

TRIAL REGISTRATION: ACTRN12620001163998, November 2020.