Cost-Effectiveness of a Program to Prevent Depression Relapse in Primary Care

Bibliographic Data

ID9099362
AuthorsGREGORY E SIMON (0000-0003-2859-5467, Group Health Cooperative, corresponding author), MICHAEL VON KORFF (Group Health Cooperative, corresponding author), Evette J Ludman, Evette Ludman (Group Health Cooperative, corresponding author), Wayne J Katon, Wayne Katon (University of Washington), Carolyn M Rutter (0000-0002-4396-8594, University of Washington), Carolyn Rutter, Jürgen Unützer (0009-0005-6585-7835, University of Washington), Elizabeth Lin (0000-0002-9653-0764, Group Health Cooperative, corresponding author), ELIZABETH H B LIN, TERRY BUSH (0000-0001-6146-769X, Group Health Cooperative, corresponding author), Edward Walker (0000-0002-2964-2635, University of Washington)
Year2002
Volume40
Issue10
Pages941-950
Publication date2002-10-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/00005650-200210000-00011
PMID12395027
OpenAlexW2085349108
LanguageEN
Citations received4
References cited27

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

Ambulatory care · Anxiety · Collaborative Care · Cost effectiveness · Depression (economics) · Health care · History of depression · Intervention (counseling) · Mental health · Physical therapy · Psychiatry · Randomization · Randomized controlled trial · Relapse prevention · Digital Mental Health Interventions · Internal Medicine · Medicine · Mental Health Treatment and Access · Treatment of Major Depression

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