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Economic evaluation of a minimal psychological intervention in chronically ill elderly patients with minor or mild to moderate depression: A randomized trial (the DELTA-study)

Published online by Cambridge University Press:  22 October 2009

Catharina C. M. Jonkers ,
Femke Lamers ,
Silvia M. A. A. Evers ,
Hans Bosma ,
Job F. Metsemakers  and
Jacques Th. M. Van Eijk
Catharina C. M. Jonkers
Affiliation:
Maastricht University
Femke Lamers
Affiliation:
Maastricht University
Silvia M. A. A. Evers
Affiliation:
Maastricht University
Hans Bosma
Affiliation:
Maastricht University
Job F. Metsemakers
Affiliation:
Maastricht University
Jacques Th. M. Van Eijk
Affiliation:
Maastricht University
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Abstract

Objectives: Depression is associated with high healthcare utilization and related costs. Effective treatments might reduce the economic burden. The objective of this study was to establish the cost-utility of a minimal psychological intervention (MPI) aimed at reducing depression and improving quality of life in elderly persons with diabetes or chronic obstructive pulmonary disease and co-occurring minor, mild, or moderate depression.

Methods: Trial-based cost-utility analysis was used to compare the MPI with usual care. Annual costs and quality-adjusted life-years (QALYs) based on the Euroqol (EQ5D) and on depression-free days were calculated.

Results: Annual costs and effects were not significantly different for the MPI group and care as usual. Bootstrap analysis indicated a dominant intervention, with a probability of 63 percent that the MPI is less costly and more effective than usual care.

Conclusions: The cost-effectiveness analysis does not support dissemination of the MPI in its current form. The economic evaluation study showed limited probability that MPI is cost-effective over usual care. Further adjustments to the MPI are needed to make the intervention suitable for dissemination in regular care. Trial registration: isrctn.org, identifier: ISRCTN92331982.

Keywords

Cost-benefit analysisDepressive disorderAgedChronic diseaseQuality of life
Type
General Essays
Information
International Journal of Technology Assessment in Health Care , Volume 25 , Issue 4 , October 2009 , pp. 497 - 504
Copyright
Copyright © Cambridge University Press 2009

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