TY - JOUR
KW - Aged
KW - Aged, 80 and over
KW - Anxiety Disorders/economics/prevention & control
KW - Community Mental Health Services/economics/methods
KW - Cost-Benefit Analysis
KW - Depressive Disorder/economics/prevention & control
KW - Female
KW - Health Care Costs/statistics & numerical data
KW - Humans
KW - Male
KW - Netherlands
KW - Patient Acceptance of Health Care
KW - Primary Health Care/economics/methods
KW - Psychiatric Status Rating Scales
KW - Sensitivity and Specificity
KW - Treatment Outcome
AU - Van't Veer-Tazelaar
AU - F. Smit
AU - H. van Hout
AU - P. van Oppen
AU - H. van der Horst
AU - A. Beekman
AU - H. van Marwijk
A1 - 
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.
BT - The British journal of psychiatry : the journal of mental science
C5 - Financing & Sustainability
CY - England
DO - 10.1192/bjp.bp.109.069617
JF - The British journal of psychiatry : the journal of mental science
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.
PP - England
PY - 2010
SN - 1472-1465; 0007-1250
SP - 319
EP - 325
EP - 
T1 - Cost-effectiveness of a stepped care intervention to prevent depression and anxiety in late life: Randomised trial
T2 - The British journal of psychiatry : the journal of mental science
TI - Cost-effectiveness of a stepped care intervention to prevent depression and anxiety in late life: Randomised trial
U1 - Financing & Sustainability
U2 - 20357310
U3 - 10.1192/bjp.bp.109.069617
VL - 196
VO - 1472-1465; 0007-1250
Y1 - 2010
ER -