JMIR Publications

ABSTRACT

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 specialised mental health care delivered by setting up, implementing their 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 healthcare system will be community-based recovery-oriented care (CMHT). In each site, 180 consenting patients will be randomised to either CAU or CMHT. Patient-level outcomes are personal and social functioning and quality adjusted life years (QALYs). Data on the participants’ healthcare use will be collected and corresponding healthcare costs will be computed. This enables evaluation of healthcare costs of CMHT vis-à-vis/compared to CAU and these costs can be related to patient-level outcomes (functioning, QALY gains) in the health-economic evaluation. The results of the outcome evaluations will be reported for each of the five countries apart, and the five trials will be pooled for multi-level analysis on the combined dataset.

Results:

NA

Conclusions:

Results of the health economic evaluation of Recover-E 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. Clinical Trial: The five trial have been registered separately for every site: 1) NCT03922425 (Bulgaria); 2) NCT03862209 (Croatia); 3) NCT03892473 (Macedonia); 4) NCT03837340 (Montenegro); 5) NCT03884933 (Romania).