Economic evaluation of a minimal psychological intervention in chronically ill elderly patients with minor or mild to moderate depression: A randomized trial (the DELTA-study)
Objectives: Depression is associated with high healthcare utilization and related costs. Effective treatments might reduce the economic burden. The objective of this study was to establish the cost-utility of a minimal psychological intervention (MPI) aimed at reducing depression and improving quali...
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| Veröffentlicht in: | International journal of technology assessment in health care 2009-10, Vol.25 (4), p.497-504 |
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| creator | Jonkers, Catharina C. M. Lamers, Femke Evers, Silvia M. A. A. Bosma, Hans Metsemakers, Job F. Van Eijk, Jacques Th. M. |
| description | Objectives: Depression is associated with high healthcare utilization and related costs. Effective treatments might reduce the economic burden. The objective of this study was to establish the cost-utility of a minimal psychological intervention (MPI) aimed at reducing depression and improving quality of life in elderly persons with diabetes or chronic obstructive pulmonary disease and co-occurring minor, mild, or moderate depression. Methods: Trial-based cost-utility analysis was used to compare the MPI with usual care. Annual costs and quality-adjusted life-years (QALYs) based on the Euroqol (EQ5D) and on depression-free days were calculated. Results: Annual costs and effects were not significantly different for the MPI group and care as usual. Bootstrap analysis indicated a dominant intervention, with a probability of 63 percent that the MPI is less costly and more effective than usual care. Conclusions: The cost-effectiveness analysis does not support dissemination of the MPI in its current form. The economic evaluation study showed limited probability that MPI is cost-effective over usual care. Further adjustments to the MPI are needed to make the intervention suitable for dissemination in regular care. Trial registration: isrctn.org, identifier: ISRCTN92331982. |
| doi_str_mv | 10.1017/S026646230999050X |
| format | Article |
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M. ; Lamers, Femke ; Evers, Silvia M. A. A. ; Bosma, Hans ; Metsemakers, Job F. ; Van Eijk, Jacques Th. M.</creator><creatorcontrib>Jonkers, Catharina C. M. ; Lamers, Femke ; Evers, Silvia M. A. A. ; Bosma, Hans ; Metsemakers, Job F. ; Van Eijk, Jacques Th. M.</creatorcontrib><description>Objectives: Depression is associated with high healthcare utilization and related costs. Effective treatments might reduce the economic burden. The objective of this study was to establish the cost-utility of a minimal psychological intervention (MPI) aimed at reducing depression and improving quality of life in elderly persons with diabetes or chronic obstructive pulmonary disease and co-occurring minor, mild, or moderate depression. Methods: Trial-based cost-utility analysis was used to compare the MPI with usual care. Annual costs and quality-adjusted life-years (QALYs) based on the Euroqol (EQ5D) and on depression-free days were calculated. Results: Annual costs and effects were not significantly different for the MPI group and care as usual. Bootstrap analysis indicated a dominant intervention, with a probability of 63 percent that the MPI is less costly and more effective than usual care. Conclusions: The cost-effectiveness analysis does not support dissemination of the MPI in its current form. The economic evaluation study showed limited probability that MPI is cost-effective over usual care. Further adjustments to the MPI are needed to make the intervention suitable for dissemination in regular care. Trial registration: isrctn.org, identifier: ISRCTN92331982.</description><identifier>ISSN: 0266-4623</identifier><identifier>EISSN: 1471-6348</identifier><identifier>DOI: 10.1017/S026646230999050X</identifier><identifier>PMID: 19845979</identifier><language>eng</language><publisher>New York, USA: Cambridge University Press</publisher><subject>Aged ; Behavior ; Behavior Therapy - economics ; Behavior Therapy - methods ; Chronic disease ; Chronic illnesses ; Chronic obstructive pulmonary disease ; Cost analysis ; Cost-Benefit Analysis ; Depression - therapy ; Depressive disorder ; Diabetes Mellitus - psychology ; Diaries ; Female ; Health care expenditures ; Health services utilization ; Hospitals ; Humans ; Male ; Medical equipment ; Medical research ; Medical screening ; Mental depression ; Nurses ; Patients ; Primary care ; Productivity ; Pulmonary Disease, Chronic Obstructive - psychology ; Quality of Life ; Quality-Adjusted Life Years ; Questionnaires ; R&D ; Research & development ; Shadow prices ; Studies</subject><ispartof>International journal of technology assessment in health care, 2009-10, Vol.25 (4), p.497-504</ispartof><rights>Copyright © Cambridge University Press 2009</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c440t-2252a83cf6c551cfce329de60947bd3eda7d54639d4876755c178e72bb3ead8f3</citedby><cites>FETCH-LOGICAL-c440t-2252a83cf6c551cfce329de60947bd3eda7d54639d4876755c178e72bb3ead8f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.cambridge.org/core/product/identifier/S026646230999050X/type/journal_article$$EHTML$$P50$$Gcambridge$$H</linktohtml><link.rule.ids>164,314,780,784,27924,27925,55628</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19845979$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jonkers, Catharina C. M.</creatorcontrib><creatorcontrib>Lamers, Femke</creatorcontrib><creatorcontrib>Evers, Silvia M. A. A.</creatorcontrib><creatorcontrib>Bosma, Hans</creatorcontrib><creatorcontrib>Metsemakers, Job F.</creatorcontrib><creatorcontrib>Van Eijk, Jacques Th. M.</creatorcontrib><title>Economic evaluation of a minimal psychological intervention in chronically ill elderly patients with minor or mild to moderate depression: A randomized trial (the DELTA-study)</title><title>International journal of technology assessment in health care</title><addtitle>Int J Technol Assess Health Care</addtitle><description>Objectives: Depression is associated with high healthcare utilization and related costs. Effective treatments might reduce the economic burden. The objective of this study was to establish the cost-utility of a minimal psychological intervention (MPI) aimed at reducing depression and improving quality of life in elderly persons with diabetes or chronic obstructive pulmonary disease and co-occurring minor, mild, or moderate depression. Methods: Trial-based cost-utility analysis was used to compare the MPI with usual care. Annual costs and quality-adjusted life-years (QALYs) based on the Euroqol (EQ5D) and on depression-free days were calculated. Results: Annual costs and effects were not significantly different for the MPI group and care as usual. Bootstrap analysis indicated a dominant intervention, with a probability of 63 percent that the MPI is less costly and more effective than usual care. Conclusions: The cost-effectiveness analysis does not support dissemination of the MPI in its current form. The economic evaluation study showed limited probability that MPI is cost-effective over usual care. Further adjustments to the MPI are needed to make the intervention suitable for dissemination in regular care. 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M.</au><au>Lamers, Femke</au><au>Evers, Silvia M. A. A.</au><au>Bosma, Hans</au><au>Metsemakers, Job F.</au><au>Van Eijk, Jacques Th. M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Economic evaluation of a minimal psychological intervention in chronically ill elderly patients with minor or mild to moderate depression: A randomized trial (the DELTA-study)</atitle><jtitle>International journal of technology assessment in health care</jtitle><addtitle>Int J Technol Assess Health Care</addtitle><date>2009-10</date><risdate>2009</risdate><volume>25</volume><issue>4</issue><spage>497</spage><epage>504</epage><pages>497-504</pages><issn>0266-4623</issn><eissn>1471-6348</eissn><abstract>Objectives: Depression is associated with high healthcare utilization and related costs. Effective treatments might reduce the economic burden. The objective of this study was to establish the cost-utility of a minimal psychological intervention (MPI) aimed at reducing depression and improving quality of life in elderly persons with diabetes or chronic obstructive pulmonary disease and co-occurring minor, mild, or moderate depression. Methods: Trial-based cost-utility analysis was used to compare the MPI with usual care. Annual costs and quality-adjusted life-years (QALYs) based on the Euroqol (EQ5D) and on depression-free days were calculated. Results: Annual costs and effects were not significantly different for the MPI group and care as usual. Bootstrap analysis indicated a dominant intervention, with a probability of 63 percent that the MPI is less costly and more effective than usual care. Conclusions: The cost-effectiveness analysis does not support dissemination of the MPI in its current form. The economic evaluation study showed limited probability that MPI is cost-effective over usual care. Further adjustments to the MPI are needed to make the intervention suitable for dissemination in regular care. Trial registration: isrctn.org, identifier: ISRCTN92331982.</abstract><cop>New York, USA</cop><pub>Cambridge University Press</pub><pmid>19845979</pmid><doi>10.1017/S026646230999050X</doi><tpages>8</tpages></addata></record> |
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| subjects | Aged Behavior Behavior Therapy - economics Behavior Therapy - methods Chronic disease Chronic illnesses Chronic obstructive pulmonary disease Cost analysis Cost-Benefit Analysis Depression - therapy Depressive disorder Diabetes Mellitus - psychology Diaries Female Health care expenditures Health services utilization Hospitals Humans Male Medical equipment Medical research Medical screening Mental depression Nurses Patients Primary care Productivity Pulmonary Disease, Chronic Obstructive - psychology Quality of Life Quality-Adjusted Life Years Questionnaires R&D Research & development Shadow prices Studies |
| title | Economic evaluation of a minimal psychological intervention in chronically ill elderly patients with minor or mild to moderate depression: A randomized trial (the DELTA-study) |
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