A personalized intervention to prevent depression in primary care: cost-effectiveness study nested into a clustered randomized trial

Background: 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 ab...

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Autores: Fernandez, A, Mendive, JM, Conejo-Ceron, S, Moreno-Peral, P, King, M, Nazareth, I, Martin-Perez, C, Fernandez-Alonso, C, Rodriguez-Bayon, A, Aiarzaguena, JM, Monton-Franco, C, Serrano-Blanco, A, Ibanez-Casas, I, Rodriguez-Sanchez, E, Salvador-Carulla, L, Garay, PB, Ballesta-Rodriguez, MI, LaFuente, P, Munoz-Garcia, MD, Minguez-Gonzalo, P, Araujo, L, Palao, D, Gomez, MC, Zubiaga, F, Navas-Campana, D, Aranda-Regules, JM, Rodriguez-Morejon, A, Luna, JD, Bellon, JA
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2018
País:España
Institución:Institut d'Investigació i Innovació Parc Taulí (I3PT)
Repositorio:r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
OAI Identifier:oai:i3pt.fundanetsuite.com:p4069
Acceso en línea:https://i3pt.portalinvestigacion.com/publicaciones/4069
Access Level:acceso abierto
Palabra clave:Depression
Risk assessment
Cost-effectiveness
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spelling A personalized intervention to prevent depression in primary care: cost-effectiveness study nested into a clustered randomized trialFernandez, AMendive, JMConejo-Ceron, SMoreno-Peral, PKing, MNazareth, IMartin-Perez, CFernandez-Alonso, CRodriguez-Bayon, AAiarzaguena, JMMonton-Franco, CSerrano-Blanco, AIbanez-Casas, IRodriguez-Sanchez, ESalvador-Carulla, LGaray, PBBallesta-Rodriguez, MILaFuente, PMunoz-Garcia, MDMinguez-Gonzalo, PAraujo, LPalao, DGomez, MCZubiaga, FNavas-Campana, DAranda-Regules, JMRodriguez-Morejon, ALuna, JDBellon, JADepressionRisk assessmentCost-effectivenessBackground: 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. Methods: 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. Results: With a willingness-to-pay threshold of (sic)10,000 ((sic)8568) the probability of cost-effectiveness oscillated from 83% (societal perspective) to 89% (health perspective). If the threshold was increased to (sic)30,000 ((sic)25,704), the probability of being considered cost-effective was 94% (societal perspective) and 96%, respectively (health perspective). The sensitivity analysis confirmed these results. Conclusions: 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.BMC2018info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://i3pt.portalinvestigacion.com/publicaciones/4069BMC MedicineISSN: 17417015reponame:r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulíinstname:Institut d'Investigació i Innovació Parc Taulí (I3PT)Inglésinfo:eu-repo/semantics/openAccessoai:i3pt.fundanetsuite.com:p40692026-06-21T15:30:37Z
dc.title.none.fl_str_mv A personalized intervention to prevent depression in primary care: cost-effectiveness study nested into a clustered randomized trial
title A personalized intervention to prevent depression in primary care: cost-effectiveness study nested into a clustered randomized trial
spellingShingle A personalized intervention to prevent depression in primary care: cost-effectiveness study nested into a clustered randomized trial
Fernandez, A
Depression
Risk assessment
Cost-effectiveness
title_short A personalized intervention to prevent depression in primary care: cost-effectiveness study nested into a clustered randomized trial
title_full A personalized intervention to prevent depression in primary care: cost-effectiveness study nested into a clustered randomized trial
title_fullStr A personalized intervention to prevent depression in primary care: cost-effectiveness study nested into a clustered randomized trial
title_full_unstemmed A personalized intervention to prevent depression in primary care: cost-effectiveness study nested into a clustered randomized trial
title_sort A personalized intervention to prevent depression in primary care: cost-effectiveness study nested into a clustered randomized trial
dc.creator.none.fl_str_mv Fernandez, A
Mendive, JM
Conejo-Ceron, S
Moreno-Peral, P
King, M
Nazareth, I
Martin-Perez, C
Fernandez-Alonso, C
Rodriguez-Bayon, A
Aiarzaguena, JM
Monton-Franco, C
Serrano-Blanco, A
Ibanez-Casas, I
Rodriguez-Sanchez, E
Salvador-Carulla, L
Garay, PB
Ballesta-Rodriguez, MI
LaFuente, P
Munoz-Garcia, MD
Minguez-Gonzalo, P
Araujo, L
Palao, D
Gomez, MC
Zubiaga, F
Navas-Campana, D
Aranda-Regules, JM
Rodriguez-Morejon, A
Luna, JD
Bellon, JA
author Fernandez, A
author_facet Fernandez, A
Mendive, JM
Conejo-Ceron, S
Moreno-Peral, P
King, M
Nazareth, I
Martin-Perez, C
Fernandez-Alonso, C
Rodriguez-Bayon, A
Aiarzaguena, JM
Monton-Franco, C
Serrano-Blanco, A
Ibanez-Casas, I
Rodriguez-Sanchez, E
Salvador-Carulla, L
Garay, PB
Ballesta-Rodriguez, MI
LaFuente, P
Munoz-Garcia, MD
Minguez-Gonzalo, P
Araujo, L
Palao, D
Gomez, MC
Zubiaga, F
Navas-Campana, D
Aranda-Regules, JM
Rodriguez-Morejon, A
Luna, JD
Bellon, JA
author_role author
author2 Mendive, JM
Conejo-Ceron, S
Moreno-Peral, P
King, M
Nazareth, I
Martin-Perez, C
Fernandez-Alonso, C
Rodriguez-Bayon, A
Aiarzaguena, JM
Monton-Franco, C
Serrano-Blanco, A
Ibanez-Casas, I
Rodriguez-Sanchez, E
Salvador-Carulla, L
Garay, PB
Ballesta-Rodriguez, MI
LaFuente, P
Munoz-Garcia, MD
Minguez-Gonzalo, P
Araujo, L
Palao, D
Gomez, MC
Zubiaga, F
Navas-Campana, D
Aranda-Regules, JM
Rodriguez-Morejon, A
Luna, JD
Bellon, JA
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Depression
Risk assessment
Cost-effectiveness
topic Depression
Risk assessment
Cost-effectiveness
description Background: 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. Methods: 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. Results: With a willingness-to-pay threshold of (sic)10,000 ((sic)8568) the probability of cost-effectiveness oscillated from 83% (societal perspective) to 89% (health perspective). If the threshold was increased to (sic)30,000 ((sic)25,704), the probability of being considered cost-effective was 94% (societal perspective) and 96%, respectively (health perspective). The sensitivity analysis confirmed these results. Conclusions: 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.
publishDate 2018
dc.date.none.fl_str_mv 2018
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://i3pt.portalinvestigacion.com/publicaciones/4069
url https://i3pt.portalinvestigacion.com/publicaciones/4069
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv BMC
publisher.none.fl_str_mv BMC
dc.source.none.fl_str_mv BMC Medicine
ISSN: 17417015
reponame:r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
instname:Institut d'Investigació i Innovació Parc Taulí (I3PT)
instname_str Institut d'Investigació i Innovació Parc Taulí (I3PT)
reponame_str r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
collection r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
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