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

dc.contributor.authorFernández, Anna
dc.contributor.authorMendive, Juan M
dc.contributor.authorConejo-Cerón, Sonia
dc.contributor.authorMoreno-Peral, Patricia
dc.contributor.authorKing, Michael
dc.contributor.authorNazareth, Irwin
dc.contributor.authorMartín-Pérez, Carlos
dc.contributor.authorFernández-Alonso, Carmen
dc.contributor.authorRodríguez-Bayón, Antonina
dc.contributor.authorAiarzaguena, Jose Maria
dc.contributor.authorMontón-Franco, Carmen
dc.contributor.authorSerrano-Blanco, Antoni
dc.contributor.authorIbañez-Casas, Inmaculada
dc.contributor.authorRodríguez-Sánchez, Emiliano
dc.contributor.authorSalvador-Carulla, Luis
dc.contributor.authorGaray, Paola Bully
dc.contributor.authorBallesta-Rodríguez, María Isabel
dc.contributor.authorLaFuente, Pilar
dc.contributor.authorDel Mar Muñoz-García, María
dc.contributor.authorMínguez-Gonzalo, Pilar
dc.contributor.authorAraujo, Luz
dc.contributor.authorPalao, Diego
dc.contributor.authorGómez, María Cruz
dc.contributor.authorZubiaga, Fernando
dc.contributor.authorNavas-Campaña, Desirée
dc.contributor.authorAranda-Regules, Jose Manuel
dc.contributor.authorRodriguez-Morejón, Alberto
dc.contributor.authorde Dios Luna, Juan
dc.contributor.authorBellón, Juan Ángel
dc.date.accessioned2023-01-25T10:04:15Z
dc.date.available2023-01-25T10:04:15Z
dc.date.issued2018-02-23
dc.description.abstractDepression 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. 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. 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. 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. ClinicalTrials.gov, NCT01151982. Registered on June 29, 2010.
dc.identifier.doi10.1186/s12916-018-1005-y
dc.identifier.essn1741-7015
dc.identifier.pmcPMC5824561
dc.identifier.pmid29471877
dc.identifier.pubmedURLhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5824561/pdf
dc.identifier.unpaywallURLhttps://doi.org/10.1186/s12916-018-1005-y
dc.identifier.urihttp://hdl.handle.net/10668/12168
dc.issue.number1
dc.journal.titleBMC medicine
dc.journal.titleabbreviationBMC Med
dc.language.isoen
dc.organizationÁrea de Gestión Sanitaria Nordeste de Granada
dc.organizationJaén
dc.organizationArea de Gestión Sanitaria Norte de Jaén
dc.organizationMálaga
dc.organizationMálaga
dc.organizationValle del Guadalhorce
dc.organizationAGS- Nordeste de Granada
dc.organizationAGS - Norte de Jaén
dc.page.number28
dc.pubmedtypeJournal Article
dc.pubmedtypeMulticenter Study
dc.pubmedtypeRandomized Controlled Trial
dc.pubmedtypeResearch Support, Non-U.S. Gov't
dc.rightsAttribution 4.0 International
dc.rights.accessRightsopen access
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subjectCost-effectiveness
dc.subjectDepression
dc.subjectRisk assessment
dc.subject.meshCluster Analysis
dc.subject.meshCost-Benefit Analysis
dc.subject.meshDepression
dc.subject.meshHumans
dc.subject.meshPrimary Health Care
dc.subject.meshQuality-Adjusted Life Years
dc.subject.meshRisk Assessment
dc.titleA personalized intervention to prevent depression in primary care: cost-effectiveness study nested into a clustered randomized trial.
dc.typeresearch article
dc.type.hasVersionVoR
dc.volume.number16
dspace.entity.typePublication

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