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

P.J. van 't Veer-Tazelaar, H.F.E. Smit, H.P.J. van Hout, P.C. van Oppen, H.E. van der Horst, A.T.F. Beekman, H.W.J. van Marwijk

Research output: Contribution to journalArticleAcademicpeer-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 563 (£412) per recipient and 4367 (£3196) 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 5000.

Conclusions

The prevention programme generated depression- and anxiety-free survival years in the older population at affordable cost.
Original languageUndefined/Unknown
Pages (from-to)319-325
JournalBritish Journal of Psychiatry
Volume196
Issue number4
DOIs
Publication statusPublished - 2010

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 = "BackgroundThere is an urgent need for the development of cost-effective preventive strategies to reduce the onset of mental disorders.AimsTo 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.MethodAn 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).ResultsThe intervention was successful in halving the incidence rate of depression and anxiety at 563 (£412) per recipient and 4367 (£3196) 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 5000.ConclusionsThe prevention programme generated depression- and anxiety-free survival years in the older population at affordable cost.",
author = "{van 't Veer-Tazelaar}, P.J. and H.F.E. Smit and {van Hout}, H.P.J. and {van Oppen}, P.C. and {van der Horst}, H.E. and A.T.F. Beekman and {van Marwijk}, H.W.J.",
year = "2010",
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volume = "196",
pages = "319--325",
journal = "British Journal of Psychiatry",
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Cost-effectiveness of a stepped care intervention to prevent depression and anxiety in late life: randomised trial. / van 't Veer-Tazelaar, P.J.; Smit, H.F.E.; van Hout, H.P.J.; van Oppen, P.C.; van der Horst, H.E.; Beekman, A.T.F.; van Marwijk, H.W.J.

In: British Journal of Psychiatry, Vol. 196, No. 4, 2010, p. 319-325.

Research output: Contribution to journalArticleAcademicpeer-review

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, P.J.

AU - Smit, H.F.E.

AU - van Hout, H.P.J.

AU - van Oppen, P.C.

AU - van der Horst, H.E.

AU - Beekman, A.T.F.

AU - van Marwijk, H.W.J.

PY - 2010

Y1 - 2010

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AB - BackgroundThere is an urgent need for the development of cost-effective preventive strategies to reduce the onset of mental disorders.AimsTo 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.MethodAn 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).ResultsThe intervention was successful in halving the incidence rate of depression and anxiety at 563 (£412) per recipient and 4367 (£3196) 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 5000.ConclusionsThe prevention programme generated depression- and anxiety-free survival years in the older population at affordable cost.

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