Cost-effectiveness of a stepped care intervention to prevent depression and anxiety in late life: randomised trial.

Petronella {Van't Veer-Tazelaar}; Filip Smit; Hein van Hout; Patricia van Oppen; Henriette {Van Der Horst}; Aartjan Beekman; Harm Van Marwijk

doi:10.1192/bjp.bp.109.069617

Cost-effectiveness of a stepped care intervention to prevent depression and anxiety in late life: randomised trial.

Petronella {Van't Veer-Tazelaar}, Filip Smit, Hein van Hout, Patricia van Oppen, Henriette {Van Der Horst}, Aartjan Beekman, Harm Van Marwijk

Research output: Contribution to journal › Article › peer-review

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.

Original language	English
Pages (from-to)	319-25
Number of pages	293
Journal	The British journal of psychiatry : the journal of mental science
Volume	196
Issue number	4
DOIs	https://doi.org/10.1192/bjp.bp.109.069617
Publication status	Published - Apr 2010

Keywords

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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10.1192/bjp.bp.109.069617

http://www.ncbi.nlm.nih.gov/pubmed/20357310

Cite this

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title = "Cost-effectiveness of a stepped care intervention to prevent depression and anxiety in late life: randomised trial.",

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.",

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author = "{{Van't Veer-Tazelaar}}, Petronella and Filip Smit and {van Hout}, Hein and {van Oppen}, Patricia and {{Van Der Horst}}, Henriette and Aartjan Beekman and {Van Marwijk}, Harm",

year = "2010",

month = apr,

doi = "10.1192/bjp.bp.109.069617",

language = "English",

volume = "196",

pages = "319--25",

journal = "The British journal of psychiatry : the journal of mental science",

issn = "1472-1465",

publisher = "Cambridge University Press",

number = "4",

}

{Van't Veer-Tazelaar}, P, Smit, F, van Hout, H, van Oppen, P, {Van Der Horst}, H, Beekman, A & Van Marwijk, H 2010, 'Cost-effectiveness of a stepped care intervention to prevent depression and anxiety in late life: randomised trial.', The British journal of psychiatry : the journal of mental science, vol. 196, no. 4, pp. 319-25. https://doi.org/10.1192/bjp.bp.109.069617

TY - JOUR

T1 - Cost-effectiveness of a stepped care intervention to prevent depression and anxiety in late life: randomised trial.

AU - {Van't Veer-Tazelaar}, Petronella

AU - Smit, Filip

AU - van Hout, Hein

AU - van Oppen, Patricia

AU - {Van Der Horst}, Henriette

AU - Beekman, Aartjan

AU - Van Marwijk, Harm

PY - 2010/4

Y1 - 2010/4

N2 - 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.

AB - 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.

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KW - Community Mental Health Services: methods

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KW - Depressive Disorder: prevention {\&} control

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KW - Primary Health Care: economics

KW - Primary Health Care: methods

KW - Psychiatric Status Rating Scales

KW - Sensitivity and Specificity

KW - Treatment Outcome

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KW - anxiety disorders

KW - anxiety disorders economics

KW - anxiety disorders prevention {\&} control

KW - community mental health services

KW - community mental health services economics

KW - community mental health services methods

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KW - depressive disorder prevention {\&} control

KW - female

KW - health care costs

KW - health care costs statistics {\&} numerical data

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KW - netherlands

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KW - primary health care economics

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DO - 10.1192/bjp.bp.109.069617

M3 - Article

SN - 1472-1465

VL - 196

SP - 319

EP - 325

JO - The British journal of psychiatry : the journal of mental science

JF - The British journal of psychiatry : the journal of mental science

IS - 4

ER -

Cost-effectiveness of a stepped care intervention to prevent depression and anxiety in late life: randomised trial.

Abstract

Keywords

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