Cost-effectiveness and cost-utility study of a psychoeducational group intervention for people with depression and physical comorbidity in primary care.

Journal: Enfermeria clinica (English Edition)

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Affiliated Institutions:  Centre d'Atenció Primària Dr. Lluís Sayé, ABS Raval Nord, Institut Català de la Salut, Barcelona, Spain; Línea d'Investigació en Biomedicina, Epidemiologia i Pràctica Clínica Avançada, Facultat de Infermeria, Universitat Rovira i Virgili, Tarragona, Spain. Electronic address: arayat.bcn.ics@gencat.cat. Institut Universitarid'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain; Unitat Docent Multiprofesional, Gerència Territorial Barcelona, Institut Català de la Salut, Barcelona, Spain. Unitat Bàsica de Prevenció, Gerència Territorial Barcelona, Institut Català de la Salut, Barcelona, Spain. Institut Universitarid'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain; Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain. Línea d'Investigació en Biomedicina, Epidemiologia i Pràctica Clínica Avançada, Facultat de Infermeria, Universitat Rovira i Virgili, Tarragona, Spain.

Abstract summary 

To evaluate the cost-effectiveness and cost-utility of a psychoeducational group intervention led by primary care (PC) nurses in relation to customary care to prevent the depression and improve quality of life in patients with physical comorbidity.Economic evaluation based on data from randomized, multicenter clinical trial with blind response variables and a one-year follow-up, carried in the context of the PSICODEP study.27 PC teams from Catalonia.>50 year-old patients with depression and some physical comorbidity: diabetes mellitus type 2, ischemic heart disease, chronic obstructive pulmonary disease, and/or asthma.12 psychoeducational group sessions, 1 per week, led by 2 PC nurses with prior training.Effectiveness: depression-free days (DFD) calculated from the BDI-II and quality-adjusted life years (QALYs) from the Euroqol-5D. Direct costs: PC visits, mental health, emergencies and hospitalizations, drugs. Indirect costs: days of temporary disability (TD). The incremental cost-effectiveness ratios (ICER), cost-effectiveness (ΔCost/ΔDLD) and cost-utility (ΔCost/ΔQALY) were estimated.The study includes 380 patients (intervention group [IG] = 204; control group [CG] = 176). 81.6% women; mean age 68.4 (SD = 8.8). The IG had a higher mean cost of visits, less of hospitalizations and less TD than the CG. The difference in costs between the IG and the CG was -357.95€ (95% CI: -2026.96 to 1311.06) at one year of follow-up. There was a mean of 11.95 (95% CI: -15.98 to 39.88) more DFD in the IG than in the CG. QALYs were similar (difference -0.01, 95% CI -0.04 to 0.05). The ICERs were 29.95€/DLD and 35,795€/QALY.Psychoeducational intervention is associated with an improvement in DFD, as well as a reduction in costs at 12 months, although not significantly. QALYs were very similar between groups.

Authors & Co-authors:  Raya-Tena Fernández-San-Martín Martín-Royo Casajuana-Closas Jiménez-Herrera

Study Outcome 

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Statistics
Citations : 
Authors :  6
Identifiers
Doi : S2445-1479(24)00024-9
SSN : 2445-1479
Study Population
Male,Female
Mesh Terms
Other Terms
Atención primaria;Chronic pathology;Cost-effectiveness;Coste-efectividad;Depresión;Depression;Enfermera;Nurse;Patología crónica;Primary care;Psicoeducación;Psychoeducation
Study Design
Study Approach
Country of Study
Publication Country
Spain