TY - JOUR
KW - Antidepressive Agents/economics/therapeutic use
KW - Chi-Square Distribution
KW - Confidence Intervals
KW - Cost-Benefit Analysis
KW - Depressive Disorder/economics/prevention & control
KW - Episode of Care
KW - Humans
KW - Interviews as Topic
KW - Preventive Health Services/economics
KW - Primary Health Care/economics/methods
KW - Program Evaluation
KW - Recurrence
KW - Treatment Outcome
KW - Washington
AU - G. E. Simon
AU - M. Von Korff
AU - E. J. Ludman
AU - W. J. Katon
AU - C. Rutter
AU - J. Unutzer
AU - E. H. Lin
AU - T. Bush
AU - E. Walker
A1 - 
AB - OBJECTIVE: Evaluate the incremental cost-effectiveness of a depression relapse prevention program in primary care. MATERIALS AND METHODS: Primary care patients initiating antidepressant treatment completed a standardized telephone assessment 6-8 weeks later. Those recovered from the current episode but at high risk for relapse (based on history of recurrent depression or dysthymia) were offered randomization to usual care or a relapse prevention intervention. The intervention included systematic patient education, two psychoeducational visits with a depression prevention specialist, shared decision-making regarding maintenance pharmacotherapy, and telephone and mail monitoring of medication adherence and depressive symptoms. Outcomes in both groups were assessed via blinded telephone assessments at 3, 6, 9, and 12 months and health plan claims and accounting data. RESULTS: Intervention patients experienced 13.9 additional depression-free days during a 12-month period (95% CI, -1.5 to 29.3). Incremental costs of the intervention were $273 (95% CI, $102 to $418) for depression treatment costs only and $160 (95% CI, -$173 to $512) for total outpatient costs. Incremental cost-effectiveness ratio was $24 per depression-free day (95% CI, -$59 to $496) for depression treatment costs only and $14 per depression-free day (95% CI, -$35 to $248) for total outpatient costs. CONCLUSIONS: A program to prevent depression relapse in primary care yields modest increases in days free of depression and modest increases in treatment costs. These modest differences reflect high rates of treatment in usual care. Along with other recent studies, these findings suggest that improved care of depression in primary care is a prudent investment of health care resources.
BT - Medical care
C5 - Financing & Sustainability
CP - 10
CY - United States
DO - https://doi.org/10.1097/00005650-200210000-00011
IS - 10
JF - Medical care
N2 - OBJECTIVE: Evaluate the incremental cost-effectiveness of a depression relapse prevention program in primary care. MATERIALS AND METHODS: Primary care patients initiating antidepressant treatment completed a standardized telephone assessment 6-8 weeks later. Those recovered from the current episode but at high risk for relapse (based on history of recurrent depression or dysthymia) were offered randomization to usual care or a relapse prevention intervention. The intervention included systematic patient education, two psychoeducational visits with a depression prevention specialist, shared decision-making regarding maintenance pharmacotherapy, and telephone and mail monitoring of medication adherence and depressive symptoms. Outcomes in both groups were assessed via blinded telephone assessments at 3, 6, 9, and 12 months and health plan claims and accounting data. RESULTS: Intervention patients experienced 13.9 additional depression-free days during a 12-month period (95% CI, -1.5 to 29.3). Incremental costs of the intervention were $273 (95% CI, $102 to $418) for depression treatment costs only and $160 (95% CI, -$173 to $512) for total outpatient costs. Incremental cost-effectiveness ratio was $24 per depression-free day (95% CI, -$59 to $496) for depression treatment costs only and $14 per depression-free day (95% CI, -$35 to $248) for total outpatient costs. CONCLUSIONS: A program to prevent depression relapse in primary care yields modest increases in days free of depression and modest increases in treatment costs. These modest differences reflect high rates of treatment in usual care. Along with other recent studies, these findings suggest that improved care of depression in primary care is a prudent investment of health care resources.
PP - United States
PY - 2002
SN - 0025-7079; 0025-7079
SP - 941
EP - 950
EP - 
T1 - Cost-effectiveness of a program to prevent depression relapse in primary care
T2 - Medical care
TI - Cost-effectiveness of a program to prevent depression relapse in primary care
U1 - Financing & Sustainability
U2 - 12395027
U3 - https://doi.org/10.1097/00005650-200210000-00011
VL - 40
VO - 0025-7079; 0025-7079
Y1 - 2002
ER -