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IS TREATMENT OF DEPRESSION COST-EFFECTIVE IN PEOPLE WITH DIABETES? A SYSTEMATIC REVIEW OF THE ECONOMIC EVIDENCE

  • Farheen Jeeva (a1), Christopher Dickens (a2), Peter Coventry (a1), Christine Bundy (a3) and Linda Davies (a1)...

Abstract

Objectives: Depression is common in diabetes and linked to a wide range of adverse outcomes. UK policy indicates that depression should be treated using conventional psychological treatments in a stepped care framework. This review aimed to identify current economic evidence of psychological treatments for depression among people with diabetes.

Method: Electronic search strategies (conducted in MEDLINE, EMBASE, PsycINFO, CINAHL, NHS EED) combined clinical and economic search terms to identify full economic evaluations of the relevant interventions. Prespecified screening and inclusion criteria were used. Standardized data extraction and critical appraisal were conducted and the results summarized qualitatively.

Results: Excluding duplicates, 1,516 studies for co-morbid depression and diabetes were screened. Four economic evaluations were identified. The studies found that the interventions improved health status, reduced depression and were cost-effective compared with usual care. The studies were all U.S.-based and evaluated collaborative care programs that included psychological therapies. Critical appraisal indicated limitations with the study designs, analysis and results for all studies.

Conclusions: The review highlighted the paucity of evidence in this area. The four studies indicated the potential of interventions to reduce depression and be cost-effective compared with usual care. Two studies reported costs per QALY gained of USD 267 to USD 4,317, whilst two studies reported the intervention dominated usual care, with net savings of USD 440 to USD 612 and net gains in patient free days or QALYs.

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The online version of this article is published within an Open Access environment subject to the conditions of the Creative Commons Attribution-NonCommercial-ShareAlike licence . The written permission of Cambridge University Press must be obtained for commercial re-use.

References

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1.Goldney, RD, Phillips, PJ, Fisher, LJ, et al.Diabetes, depression, and quality of life: A population study. Diabetes Care. 2004;27:10661070.
2.Anderson, RJ, Freedland, KE, Clouse, RE, et al.The prevalence of co morbid depression in adults with diabetes: A meta analysis. Diabetes Care. 2001;24:10691078.
3.Von Korff, M, Katon, W, Lin, EH, et al.Potentially modifiable factors associated with disability among people with diabetes. Psychosom Med. 2005;67:233240.
4.Piette, JD, Heisler, M, Wagner, TH. Cost-related medication underuse among chronically III adults: The treatments people forgo, how often, and who is at risk. Am J Public Health. 2004;94:17821787.
5.Coventry, PA, Hays, R, Dickens, C, et al.Talking about depression: A qualitative study of barriers to managing depression in people with long term conditions in primary care. BMC Fam Pract. 2011;12:10.
6.Ridd, M, Shaw, A, Salisabury, C. ‘Two sides of the coin’ - the value of personal continuity to GPs: A qualitative interview study. Fam Pract. 2006;23:461468.
7.Chew-Graham, CA, Hogg, T. Patients with chronic physical illness and co-existing psychological morbidity: GPs’ views on their role in detection and management. Prim Care Psychiatry. 2002;2:3539.
8.Telford, R, Hutchinson, A, Jones, R, Rix, A, Howe, A. Obstacles to effective treatment of depression: A general practice perspective. Fam Pract. 2002;19:4552.
9.Gilbody, S, Whitty, P, Grimshaw, J, Thomas, R. Educational and organizational interventions to improve the management of depression in primary care: A systematic review. JAMA. 2003;289:31453151.
10.Katon, W, Schoenbaum, M, Fan, M, et al, the Impact Investigators. Cost-effectiveness of an intervention (IMPACT) to improve depression care in the elderly. Arch Gen Psychiatry. 2005;62:13131320.
11.Lin, EH, Katon, W, Von Korff, M, et al.IMPACT Investigators: Effect of improving depression care on pain and function among older adults with arthritis: A randomized controlled trial. JAMA. 2003;290:4282434.
12.Katon, WJ, Lin, EH, Von Korff, M, et al.Collaborative care for patients with depression and chronic illness. N Engl J Med. 2010;363:26112620.
13.Harkness, E, Macdonald, W, Valderas, J, et al., Identifying psychosocial interventions that improve both physical and mental health in patients with diabetes. Diabetes Care. 2010;33:926930.
14.Centre for Reviews and Dissemination. NHS Economic Evaluation Database Handbook, (2007). http://www.york.ac.uk/inst/crd/pdf/nhseed-handbook2007.pdf (accessed May 20, 2010).
15.Katon, W, Unutzer, J, Fan, MY, et al.Cost-effectiveness and net benefit of enhanced treatment of depression for older adults with diabetes and depression. Diabetes Care. 2006;29:265270.
16.Simon, GE, Katon, W, Elizabeth, HB, et al.Cost-effectiveness of systematic depression treatment among people with diabetes mellitus. Arch Gen Psychiatry. 2007;64:6572.
17.Hay, JW, Katon, WJ, Ell, K, et al.Cost-effectiveness analysis of collaborative care management of major depression among low-income, predominantly Hispanics with diabetes. Value Health. 2012;15:249254.
18.Katon, W, Russo, J, Lin, E, et al.Cost-effectiveness of a multicondition collaborative care intervention: A randomized controlled trial. Arch Gen Psychiatry. 2012;69:507514.
19.Unützer, J, Katon, W, Williams, JW Jr, et al.Improving primary care for depression in late life: The design of a multicenter randomized trial. Med Care. 2001;39:785799.
20.United States Department of Labor, Bureau of Labor statistics. Consumer price index. http://www.bls.gov/cpi/cpi_dr.htm (accessed October 1, 2012).
21.Payne, K, McAllister, M, Davies, LM. Valuing the economic benefits of complex interventions: When maximising health is not sufficient. Health Econ. 2013;22:258271.
22.Archer, J, Bower, P, Gilbody, S, et al.Collaborative care for depression and anxiety problems. Cochrane Database Syst Rev. 2012;10:CD006525.
23.McGregor, M, Lin, EH, Katon, WJ. TEAMcare: An integrated multicondition collaborative care program for chronic illnesses and depression. J Ambul Care Manage. 2011;34:152162.

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