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1. Impact of the COVID-19 pandemic on diagnoses of common mental health disorders in adults in Catalonia, Spain: a population-based cohort study

Author

Anna Berenguera, Talita Duarte-Salles, Sergio Fernández-Bertolín, Edward Burn, Laura Medina-Perucha, Constanza Jacques-Aviñó, Carlen Reyes, Maria Aragón, Andrea Pistillo, and Berta Raventós

Subjects
Medicine
Abstract

Objective To investigate how trends in incidence of anxiety and depressive disorders have been affected by the COVID-19 pandemic.Design Population-based cohort study.Setting Retrospective cohort study from 2018 to 2021 using the Information System for Research in Primary Care (SIDIAP) database in Catalonia, Spain.Participants 3 640 204 individuals aged 18 or older in SIDIAP on 1 March 2018 with no history of anxiety and depressive disorders.Primary and secondary outcomes measures The incidence of anxiety and depressive disorders during the prelockdown period (March 2018–February 2020), lockdown period (March–June 2020) and postlockdown period (July 2020–March 2021) was calculated. Forecasted rates over the COVID-19 periods were estimated using negative binomial regression models based on prelockdown data. The percentage of reduction was estimated by comparing forecasted versus observed events, overall and by sex, age and socioeconomic status.Results The incidence rates per 100 000 person-months of anxiety and depressive disorders were 151.1 (95% CI 150.3 to 152.0) and 32.3 (31.9 to 32.6), respectively, during the prelockdown period. We observed an increase of 37.1% (95% prediction interval 25.5 to 50.2) in incident anxiety diagnoses compared with the expected in March 2020, followed by a reduction of 15.8% (7.3 to 23.5) during the postlockdown period. A reduction in incident depressive disorders occurred during the lockdown and postlockdown periods (45.6% (39.2 to 51.0) and 22.0% (12.6 to 30.1), respectively). Reductions were higher among women during the lockdown period, adults aged 18–34 years and individuals living in the most deprived areas.Conclusions The COVID-19 pandemic in Catalonia was associated with an initial increase in anxiety disorders diagnosed in primary care but a reduction in cases as the pandemic continued. Diagnoses of depressive disorders were lower than expected throughout the pandemic.

Published
2022
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2. Cost-effectiveness of unicompartmental compared with total knee replacement: a population-based study using data from the National Joint Registry for England and Wales

Author

Rafael Pinedo-Villanueva, Hemant Pandit, Edward Burn, Andrew Judge, Thomas W. Hamilton, Alexander D. Liddle, David W. Murray, Arthritis Research UK, and Royal College of Surgeons of England

Subjects
Male, Cost effectiveness, Cost-Benefit Analysis, medicine.medical_treatment, Psychological intervention, knee, Osteoarthritis, 0302 clinical medicine, USAGE, Registries, 030212 general & internal medicine, total knee replacement, Arthroplasty, Replacement, Knee, OUTCOMES, 030222 orthopedics, General Medicine, Middle Aged, Osteoarthritis, Knee, REVISION, Total knee replacement, surgical procedures, operative, England, unicompartmental knee replacement, Female, Life Sciences & Biomedicine, musculoskeletal diseases, medicine.medical_specialty, MATCHED PATIENTS, Unicompartmental knee replacement, UNICONDYLAR, Arthroplasty, 03 medical and health sciences, Health Economics, Medicine, General & Internal, General & Internal Medicine, medicine, Humans, Knee, ARTHROPLASTY, Aged, Science & Technology, Wales, business.industry, Research, medicine.disease, Population based study, osteoarthritis, Propensity score matching, Physical therapy, business
Abstract

Objectives To assess the value for money of unicompartmental knee replacement (UKR) compared with total knee replacement (TKR). Design A lifetime Markov model provided the framework for the analysis. Setting Data from the National Joint Registry (NJR) for England and Wales primarily informed the analysis. Participants Propensity score matched patients in the NJR who received either a UKR or TKR. Interventions UKR is a less invasive alternative to TKR, where only the compartment affected by osteoarthritis is replaced. Primary outcome measures Incremental quality-adjusted life years (QALYs) and healthcare system costs. Results The provision of UKR is expected to lead to a gain in QALYs compared with TKR for all age and gender subgroups (male: Conclusions UKR can be expected to generate better health outcomes and lower lifetime costs than TKR. Surgeon usage of UKR does, however, have a significant impact on the cost-effectiveness of the procedure. To achieve the best results, surgeons need to perform a sufficient proportion of knee replacements as UKR. Low usage surgeons may therefore need to broaden their indications for UKR.

Published
2018

3. The cost-effectiveness of the MobileMums intervention to increase physical activity among mothers with young children: a Markov model informed by a randomised controlled trial

Author

Edward Burn, Adrian G. Barnett, Nicholas Graves, Alison L. Marshall, Brianna S. Fjeldsoe, and Yvette D. Miller

Subjects
Health Knowledge, Attitudes, Practice, Cost effectiveness, Cost-Benefit Analysis, law.invention, 0302 clinical medicine, Randomized controlled trial, law, Surveys and Questionnaires, Health care, Medicine, 030212 general & internal medicine, health care economics and organizations, Cost–benefit analysis, 030503 health policy & services, Health services research, General Medicine, Markov Chains, 3. Good health, mHealth, Cohort, Female, Queensland, 0305 other medical science, Adult, medicine.medical_specialty, Mothers, Health Promotion, behaviour change, 03 medical and health sciences, Humans, Sports and Exercise Medicine, Exercise, Text Messaging, Health economics, business.industry, Research, Australia, Social Support, Economic evaluation, Clinical trial, Quality of Life, Physical therapy, Sedentary Behavior, business, Risk Reduction Behavior, Cell Phone, Program Evaluation
Abstract

Objectives To determine the cost-effectiveness of the MobileMums intervention. MobileMums is a 12-week programme which assists mothers with young children to be more physically active, primarily through the use of personalised SMS text-messages. Design A cost-effectiveness analysis using a Markov model to estimate and compare the costs and consequences of MobileMums and usual care. Setting This study considers the cost-effectiveness of MobileMums in Queensland, Australia. Participants A hypothetical cohort of over 36 000 women with a child under 1 year old is considered. These women are expected to be eligible and willing to participate in the intervention in Queensland, Australia. Data sources The model was informed by the effectiveness results from a 9-month two-arm community-based randomised controlled trial undertaken in 2011 and registered retrospectively with the Australian Clinical Trials Registry (ACTRN12611000481976). Baseline characteristics for the model cohort, treatment effects and resource utilisation were all informed by this trial. Main outcome measures The incremental cost per quality-adjusted life year (QALY) of MobileMums compared with usual care. Results The intervention is estimated to lead to an increase of 131 QALYs for an additional cost to the health system of 1.1 million Australian dollars (AUD). The expected incremental cost-effectiveness ratio for MobileMums is 8608 AUD per QALY gained. MobileMums has a 98% probability of being cost-effective at a cost-effectiveness threshold of 64 000 AUD. Varying modelling assumptions has little effect on this result. Conclusions At a cost-effectiveness threshold of 64 000 AUD, MobileMums would likely be a cost-effective use of healthcare resources in Queensland, Australia. Trial registration number Australian Clinical Trials Registry; ACTRN12611000481976.

Published
2015

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