Preventing Depression in Adults With Subthreshold Depression: Health-Economic Evaluation Alongside a Pragmatic Randomized Controlled Trial of a Web-Based Intervention

Publikation: Beiträge in ZeitschriftenZeitschriftenaufsätzeTransferbegutachtet

Authors

  • Claudia Buntrock
  • Matthias Berking
  • Filip Smit
  • Dirk Lehr
  • Stephanie Nobis
  • Heleen Riper
  • Pim Cuijpers
  • David Daniel Ebert

Background: Psychological interventions for the prevention of depression might be a cost-effective way to reduce the burden associated with depressive disorders. Objective: To evaluate the cost-effectiveness of a Web-based guided self-help intervention to prevent major depressive disorder (MDD) in people with subthreshold depression (sD). Methods: A pragmatic randomized controlled trial was conducted with follow-up at 12 months. Participants were recruited from the general population via a large statutory health insurance company and an open access website. Participants were randomized to a Web-based guided self-help intervention (ie, cognitive-behavioral therapy and problem-solving therapy assisted by supervised graduate students or health care professionals) in addition to usual care or to usual care supplemented with Web-based psycho-education (enhanced usual care). Depression-free years (DFYs) were assessed by blinded diagnostic raters using the telephone-administered Structured Clinical Interview for DSM-IV Axis Disorders at 6- and 12-month follow-up, covering the period to the previous assessment. Costs were self-assessed through a questionnaire. Costs measured from a societal and health care perspective were related to DFYs and quality-adjusted life years (QALYs). Results: In total, 406 participants were enrolled in the trial. The mean treatment duration was 5.84 (SD 4.37) weeks. On average, participants completed 4.93 of 6 sessions. Significantly more DFYs were gained in the intervention group (0.82 vs 0.70). Likewise, QALY health gains were in favor of the intervention, but only statistically significant when measured with the more sensitive SF-6D. The incremental per-participant costs were €136 (£116). Taking the health care perspective and assuming a willingness-to-pay of €20,000 (£17,000), the intervention's likelihood of being cost-effective was 99% for gaining a DFY and 64% or 99% for gaining an EQ-5D or a SF-6D QALY. Conclusions: Our study supports guidelines recommending Web-based treatment for sD and adds that this not only restores health in people with sD, but additionally reduces the risk of developing a MDD. Offering the intervention has an acceptable likelihood of being more cost-effective than enhanced usual care and could therefore reach community members on a wider scale. Trial registration: German Clinical Trials Register: DRKS00004709; http://www.drks.de/DRKS00004709 (Archived by WebCite at http://www.webcitation.org/6kAZVUxy9).

OriginalspracheEnglisch
Aufsatznummere5
ZeitschriftJournal of Medical Internet Research
Jahrgang19
Ausgabenummer1
Anzahl der Seiten16
ISSN1439-4456
DOIs
PublikationsstatusErschienen - 04.01.2017

Dokumente

DOI

Zuletzt angesehen

Forschende

  1. Björn Dietrich

Publikationen

  1. Introduction
  2. Interrogating urban crisis
  3. ... address unknown?
  4. Modelling and simulation of dynamic microstructure evolution of aluminium alloys during thermomechanically coupled extrusion process
  5. Scenarios for coal-exit in Germany-a model-based analysis and implications in the European context
  6. Development of an experimental device allowing plant-plant interaction studies and in situ dynamic trapping of volatile organic compounds emitted by barley (Hordeum distichon L.) roots
  7. Article 66 CISG
  8. Rationality and Sin
  9. Vision als Aufgabe
  10. Liquidity, Flows, Circulation
  11. Effectiveness and Moderators of an Internet-Based Mobile-Supported Stress Management Intervention as a Universal Prevention Approach
  12. Spaces with a temper
  13. Kriminalisierung und Versicherheitlichung von Migration. Editorial
  14. Truth in labeling
  15. Learning from Down Under
  16. Influence of cerium on the formation of micro-galvanic corrosion elements of AZ91
  17. Eco-Design
  18. Community and Training in NFDI4DS
  19. Fallstudie
  20. Experimental Setup of Dieless Drawing Process for Magnesium Wire
  21. The role of self-evaluation in predicting attitudes toward supporters of COVID-19-related conspiracy theories
  22. Notting Hill Gate 3 Basic
  23. Mining User-Generated Financial Content to Predict Stock Price Movements
  24. Do unfair perceived own pay and top managers’ pay erode satisfaction with democracy?
  25. Facing Apathy in Joyce Carol Oates’ “Death Watch”
  26. Effects of grade retention on achievement and self-concept in science and mathematics
  27. Grain refinements of magnesium alloys inoculated by additions of external SiC particles
  28. Constructing small talk in learner-native speaker voice-based telecollaboration
  29. The Altmark Trans judgment: consequences for the hospital sector
  30. Effects of introspective vs. extraspective instruction in scaling of hedonic properties of flavouring ingredients by Chinese and German subjects
  31. Media of Trust
  32. Exploring the influence of testimonial source on attitudes towards e-mental health interventions among university students
  33. German multiple-product, multiple-destination exporters: Bernard-Redding-Schott under test
  34. Article 71 CISG
  35. The impact of mindfulness on well-being and performance in the workplace