Cost-effectiveness of a stepped care intervention to prevent depression and anxiety in late life: randomised trial
Copyright policy )Cost-effectiveness of a stepped care intervention to prevent depression and anxiety in late life: randomised trial
BackgroundThere is an urgent need for the development of cost-effective preventive strategies to reduce the onset of mental disorders.AimsTo establish the cost-effectiveness of a stepped care preventive intervention for depression and anxiety disorders in older people at high risk of these conditions, compared with routine primary care.MethodAn economic evaluation was conducted alongside a pragmatic randomised controlled trial (ISRCTN26474556). Consenting individuals presenting with subthreshold levels of depressive or anxiety symptoms were randomly assigned to a preventive stepped care programme (n = 86) or to routine primary care (n = 84).ResultsThe intervention was successful in halving the incidence rate of depression and anxiety at €563 (£412) per recipient and €4367 (£3196) per disorder-free year gained, compared with routine primary care. The latter would represent good value for money if the willingness to pay for a disorder-free year is at least €5000.ConclusionsThe prevention programme generated depression- and anxiety-free survival years in the older population at affordable cost.
- EMGO Institute for Health and Care Research Netherlands
- Amsterdam UMC Netherlands
- Vanderbilt University Medical Center United States
- Vrije Universiteit Amsterdam Netherlands
- Trimbos Institute Netherlands
Male, Community Mental Health Services: methods, Cost-Benefit Analysis, netherlands, depressive disorder prevention {\&} control, Anxiety Disorders: prevention {\&} control, Health Care Costs: statistics {\&} numerical data, patient acceptance health care, depressive disorder, primary health care methods, Community Mental Health Services: economics, cost benefit analysis, 80 and over, humans, Netherlands, health care costs statistics {\&} numerical data, Aged, 80 and over, Primary Health Care: methods, Health Care Costs, Anxiety Disorders, community mental health services economics, Community Mental Health Services, community mental health services methods, Depressive Disorder: prevention {\&} control, aged, female, Treatment Outcome, Female, community mental health services, Primary Health Care: economics, Sensitivity and Specificity, anxiety disorders, male, sensitivity specificity, health care costs, Humans, depressive disorder economics, 80 over, Aged, Psychiatric Status Rating Scales, Depressive Disorder, Primary Health Care, psychiatric status rating scales, anxiety disorders economics, Patient Acceptance of Health Care, Depressive Disorder: economics, primary health care, anxiety disorders prevention {\&} control, primary health care economics, treatment outcome, Anxiety Disorders: economics
Male, Community Mental Health Services: methods, Cost-Benefit Analysis, netherlands, depressive disorder prevention {\&} control, Anxiety Disorders: prevention {\&} control, Health Care Costs: statistics {\&} numerical data, patient acceptance health care, depressive disorder, primary health care methods, Community Mental Health Services: economics, cost benefit analysis, 80 and over, humans, Netherlands, health care costs statistics {\&} numerical data, Aged, 80 and over, Primary Health Care: methods, Health Care Costs, Anxiety Disorders, community mental health services economics, Community Mental Health Services, community mental health services methods, Depressive Disorder: prevention {\&} control, aged, female, Treatment Outcome, Female, community mental health services, Primary Health Care: economics, Sensitivity and Specificity, anxiety disorders, male, sensitivity specificity, health care costs, Humans, depressive disorder economics, 80 over, Aged, Psychiatric Status Rating Scales, Depressive Disorder, Primary Health Care, psychiatric status rating scales, anxiety disorders economics, Patient Acceptance of Health Care, Depressive Disorder: economics, primary health care, anxiety disorders prevention {\&} control, primary health care economics, treatment outcome, Anxiety Disorders: economics
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