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Cost-effectiveness of a stepped care intervention to prevent depression and anxiety in late life: randomised trial.
{Van't Veer-Tazelaar}, Petronella; Smit, Filip; van Hout, Hein; van Oppen, Patricia; {Van Der Horst}, Henriette; Beekman, Aartjan; van Marwijk, Harm
The British journal of psychiatry : the journal of mental science. 2010;196(4):319-25.
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Abstract
BACKGROUND: There is an urgent need for the development of cost-effective preventive strategies to reduce the onset of mental disorders.AIMS: To 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.METHOD: An 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).RESULTS: The intervention was successful in halving the incidence rate of depression and anxiety at euro563 ( pound412) per recipient and euro4367 ( pound3196) 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 euro5000.CONCLUSIONS: The prevention programme generated depression- and anxiety-free survival years in the older population at affordable cost.
Keyword(s)
80 and over; 80 over; Aged; Anxiety Disorders; Anxiety Disorders: economics; Anxiety Disorders: prevention {\&} control; Community Mental Health Services; Community Mental Health Services: economics; Community Mental Health Services: methods; Cost-Benefit Analysis; Depressive Disorder; Depressive Disorder: economics; Depressive Disorder: prevention {\&} control; Female; Health Care Costs; Health Care Costs: statistics {\&} numerical data; Humans; Male; Netherlands; Patient Acceptance of Health Care; Primary Health Care; Primary Health Care: economics; Primary Health Care: methods; Psychiatric Status Rating Scales; Sensitivity and Specificity; Treatment Outcome; aged; anxiety disorders; anxiety disorders economics; anxiety disorders prevention {\&} control; community mental health services; community mental health services economics; community mental health services methods; cost benefit analysis; depressive disorder; depressive disorder economics; depressive disorder prevention {\&} control; female; health care costs; health care costs statistics {\&} numerical data; humans; male; netherlands; patient acceptance health care; primary health care; primary health care economics; primary health care methods; psychiatric status rating scales; sensitivity specificity; treatment outcome
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- Related website http://www.ncbi.nlm.nih.gov/pubmed/20357310