de Oliveira Claire, Mason Joyce, Amani Bahar, Liddell Gray, Szatmari Peter, Henderson Jo, Courtney Darren
Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health , Toronto, Ontario, Canada.
BMJ Open. 2025 May 15;15(5):e092541. doi: 10.1136/bmjopen-2024-092541.
Depressive disorders in adolescents are highly prevalent and debilitating and are a risk factor for self-harm and death by suicide. In the context of recovery from the COVID-19 pandemic, strained healthcare resources are compounded by an increased demand for treatment services for adolescents with depression. The objective of this study protocol is to delineate the proposed economic evaluation of an integrated care pathway for depression in adolescents within the Care for Adolescents who Received Information 'Bout Outcomes, 2nd iteration (CARIBOU-2) non-randomised, cluster-controlled trial.
Two economic evaluations of the CARIBOU-2 trial (n=300) will be conducted-a cost-effectiveness analysis and a cost-utility analysis. In the cost-effectiveness analysis, we will examine the primary clinical outcome of the trial, change in the Mood and Feelings Questionnaire total score. In the cost-utility analysis, the clinical outcome will be quality-adjusted life-years, a generic measure of health burden. Data on the resources and respective costs required to deliver the intervention will be collected by the research team. Data on resource use post-intervention will be obtained from a mix of administrative data holdings and self-report; relevant unit costs will be obtained from existing data sources. The outcome of both economic evaluations will be the incremental cost-effectiveness ratio. Relevant sensitivity analyses will be undertaken, and cost-effectiveness acceptability curves will be produced to characterise any sources of uncertainty in the analysis. Equity considerations will also be examined, where relevant.
Ethical approval for the larger CARIBOU-2 trial, including the economic evaluation, has been obtained by the Centre for Addiction and Mental Health as well as site-level ethics boards (019/2021; Centre for Addiction and Mental Health). All participants will provide informed consent for their data to be analysed and reported. The results of the main trial and the economic evaluation will be submitted for publication in a peer-reviewed journal and shared with relevant policy makers across Canada.
NCT05142683.
青少年抑郁症非常普遍且使人衰弱，是自残和自杀死亡的危险因素。在从新冠疫情中恢复的背景下，医疗资源紧张，而青少年抑郁症治疗服务需求的增加使情况更加复杂。本研究方案的目的是在第二轮“了解青少年结局信息护理”（CARIBOU - 2）非随机、整群对照试验中，描述对青少年抑郁症综合护理路径拟进行的经济评估。
将对CARIBOU - 2试验（n = 300）进行两项经济评估——成本效益分析和成本效用分析。在成本效益分析中，我们将研究试验的主要临床结局，即情绪与情感问卷总分的变化。在成本效用分析中，临床结局将是质量调整生命年，这是一种衡量健康负担的通用指标。研究团队将收集实施干预所需资源及相应成本的数据。干预后资源使用的数据将从行政数据记录和自我报告的混合数据中获取；相关单位成本将从现有数据源中获取。两项经济评估的结果都将是增量成本效益比。将进行相关敏感性分析，并绘制成本效益可接受性曲线，以描述分析中任何不确定性来源。如有相关情况，还将审查公平性考量因素。
成瘾与心理健康中心以及各站点层面的伦理委员会（019/2021；成瘾与心理健康中心）已获得包括经济评估在内的更大规模CARIBOU - 2试验的伦理批准。所有参与者将对其数据进行分析和报告提供知情同意。主要试验和经济评估的结果将提交至同行评审期刊发表，并与加拿大各地的相关政策制定者分享。
NCT05142683。
