Back to Search
Start Over
A personalized intervention to prevent depression in primary care: cost-effectiveness study nested into a clustered randomized trial.
- Source :
- BMC Medicine; 2/23/2018, Vol. 16 Issue 1, p1-12, 12p, 3 Charts, 3 Graphs
- Publication Year :
- 2018
-
Abstract
- <bold>Background: </bold>Depression is viewed as a major and increasing public health issue, as it causes high distress in the people experiencing it and considerable financial costs to society. Efforts are being made to reduce this burden by preventing depression. A critical component of this strategy is the ability to assess the individual level and profile of risk for the development of major depression. This paper presents the cost-effectiveness of a personalized intervention based on the risk of developing depression carried out in primary care, compared with usual care.<bold>Methods: </bold>Cost-effectiveness analyses are nested within a multicentre, clustered, randomized controlled trial of a personalized intervention to prevent depression. The study was carried out in 70 primary care centres from seven cities in Spain. Two general practitioners (GPs) were randomly sampled from those prepared to participate in each centre (i.e. 140 GPs), and 3326 participants consented and were eligible to participate. The intervention included the GP communicating to the patient his/her individual risk for depression and personal risk factors and the construction by both GPs and patients of a psychosocial programme tailored to prevent depression. In addition, GPs carried out measures to activate and empower the patients, who also received a leaflet about preventing depression. GPs were trained in a 10- to 15-h workshop. Costs were measured from a societal and National Health care perspective. Qualityadjustedlife years were assessed using the EuroQOL five dimensions questionnaire. The time horizon was 18 months.<bold>Results: </bold>With a willingness-to-pay threshold of €10,000 (£8568) the probability of cost-effectiveness oscillated from 83% (societal perspective) to 89% (health perspective). If the threshold was increased to €30,000 (£25,704), the probability of being considered cost-effective was 94% (societal perspective) and 96%, respectively (health perspective). The sensitivity analysis confirmed these results.<bold>Conclusions: </bold>Compared with usual care, an intervention based on personal predictors of risk of depression implemented by GPs is a cost-effective strategy to prevent depression. This type of personalized intervention in primary care should be further developed and evaluated.<bold>Trial Registration: </bold>ClinicalTrials.gov, NCT01151982. Registered on June 29, 2010. [ABSTRACT FROM AUTHOR]
- Subjects :
- DIAGNOSIS of mental depression
THERAPEUTICS
MENTAL depression
PUBLIC health
GENERAL practitioners
SERVICES for physicians
PATIENT compliance
PREVENTION of mental depression
CLUSTER analysis (Statistics)
COMPARATIVE studies
COST effectiveness
RESEARCH methodology
MEDICAL cooperation
PRIMARY health care
QUESTIONNAIRES
RESEARCH
RESEARCH funding
RISK assessment
EVALUATION research
RANDOMIZED controlled trials
QUALITY-adjusted life years
ECONOMICS
Subjects
Details
- Language :
- English
- ISSN :
- 17417015
- Volume :
- 16
- Issue :
- 1
- Database :
- Complementary Index
- Journal :
- BMC Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 128157034
- Full Text :
- https://doi.org/10.1186/s12916-018-1005-y