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- PMID: 20696480
- UKPMCID: 20696480
- DOI: 10.1016/j.jad.2010.07.026
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Treatment and prevention of depression after surgery for hip fracture in older people: cost-effectiveness analysis.
Romeo, Renee; Knapp, Martin; Banerjee, Sube; Morris, Julie; Baldwin, Robert; Tarrier, Nicholas; Pendleton, Neil; Horan, Mike; Burns, Alistair
Journal of affective disorders. 2011;128(3):211-9.
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Full-text held externally
- PMID: 20696480
- UKPMCID: 20696480
- DOI: 10.1016/j.jad.2010.07.026
Abstract
OBJECTIVE: For older people who have had hip fracture surgery, to evaluate the cost-effectiveness of a nurse-led intervention in treating depression compared to treatment as usual (TAU), and to evaluate the cost-effectiveness of a psychological treatment for the prevention of depression. DESIGN: Two linked cost-effectiveness studies for the treatment and prevention of depression after hip surgery, from the perspective of health, social care, voluntary sector agencies and unpaid carers. SETTING: Orthopaedic units in Manchester, England. PARTICIPANTS: One hundred and twenty-one patients with Geriatric Depression Scale (GDS) scores greater than 6 were included in the treatment study and 172 patients with GDS scores less than or equal to 6 were enrolled in the prevention study. INTERVENTIONS: Nurse-led intervention for treating depression versus TAU; and cognitive behaviour therapy (CBT) for preventing depression following surgery for hip fracture. MAIN OUTCOME MEASURES: Outcomes were changes in HADS-depression scores at 6 weeks. Costs covered treatment and all service impacts. RESULTS: After 6 weeks, there were no significant differences in cost. However, the nurse-led intervention group had a lower mean HADS-depression score compared to TAU. In the prevention study, there were no significant differences in cost and depression score between patients treated with CBT and TAU. CONCLUSION: The results for this parallel randomized controlled study show that after hip fracture surgery a nurse-led intervention may be a cost-effective option for the treatment of depression in older people with depression. However CBT does not appear to be a cost-effective option for the prevention of depression in this population.