000069782 001__ 69782
000069782 005__ 20180413131645.0
000069782 0247_ $$2doi$$a10.1186/s12916-018-1005-y
000069782 0248_ $$2sideral$$a104929
000069782 037__ $$aART-2018-104929
000069782 041__ $$aeng
000069782 100__ $$aFernandez, A.
000069782 245__ $$aA personalized intervention to prevent depression in primary care: cost-effectiveness study nested into a clustered randomized trial
000069782 260__ $$c2018
000069782 5060_ $$aAccess copy available to the general public$$fUnrestricted
000069782 5203_ $$aBackground: Depression is viewed as a major and increasing public health issue, as it causes high distress in the people experiencing it and considerable financial costs to society. Efforts are being made to reduce this burden by preventing depression. A critical component of this strategy is the ability to assess the individual level and profile of risk for the development of major depression. This paper presents the cost-effectiveness of a personalized intervention based on the risk of developing depression carried out in primary care, compared with usual care. Methods: Cost-effectiveness analyses are nested within a multicentre, clustered, randomized controlled trial of a personalized intervention to prevent depression. The study was carried out in 70 primary care centres from seven cities in Spain. Two general practitioners (GPs) were randomly sampled from those prepared to participate in each centre (i.e. 140 GPs), and 3326 participants consented and were eligible to participate. The intervention included the GP communicating to the patient his/her individual risk for depression and personal risk factors and the construction by both GPs and patients of a psychosocial programme tailored to prevent depression. In addition, GPs carried out measures to activate and empower the patients, who also received a leaflet about preventing depression. GPs were trained in a 10- to 15-h workshop. Costs were measured from a societal and National Health care perspective. Qualityadjustedlife years were assessed using the EuroQOL five dimensions questionnaire. The time horizon was 18 months. Results: With a willingness-to-pay threshold of (sic)10, 000 ((sic)8568) the probability of cost-effectiveness oscillated from 83% (societal perspective) to 89% (health perspective). If the threshold was increased to (sic)30, 000 ((sic)25, 704), the probability of being considered cost-effective was 94% (societal perspective) and 96%, respectively (health perspective). The sensitivity analysis confirmed these results. Conclusions: Compared with usual care, an intervention based on personal predictors of risk of depression implemented by GPs is a cost-effective strategy to prevent depression. This type of personalized intervention in primary care should be further developed and evaluated.
000069782 536__ $$9info:eu-repo/grantAgreement/ES/DGA/RD06-0018-0020-Aragon group$$9info:eu-repo/grantAgreement/ES/DGA/RD12-0005-0006-Aragon group$$9info:eu-repo/grantAgreement/ES/ISCIII/PS09-00461$$9info:eu-repo/grantAgreement/ES/ISCIII/PS09-00849$$9info:eu-repo/grantAgreement/ES/ISCIII/PS09-01095$$9info:eu-repo/grantAgreement/ES/ISCIII/PS09-02147$$9info:eu-repo/grantAgreement/ES/ISCIII/PS09-02272$$9info:eu-repo/grantAgreement/ES/ISCIII/RD06-0018$$9info:eu-repo/grantAgreement/ES/ISCIII/RD12-0005-0001
000069782 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttp://creativecommons.org/licenses/by/3.0/es/
000069782 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000069782 700__ $$aMendive, J.M.
000069782 700__ $$aConejo-Ceron, S.
000069782 700__ $$aMoreno-Peral, P.
000069782 700__ $$aKing, M.
000069782 700__ $$aNazareth, I.
000069782 700__ $$aMartin-Perez, C.
000069782 700__ $$aFernandez-Alonso, C.
000069782 700__ $$aRodriguez-Bayon, A.
000069782 700__ $$aAiarzaguena, J.M.
000069782 700__ $$aMonton-Franco, C.
000069782 700__ $$aSerrano-Blanco, A.
000069782 700__ $$aIbanez-Casas, I.
000069782 700__ $$aRodriguez-Sanchez, E.
000069782 700__ $$aSalvador-Carulla, L.
000069782 700__ $$aGaray, P.B.
000069782 700__ $$aBallesta-Rodriguez, M.I.
000069782 700__ $$aLaFuente, P.
000069782 700__ $$aMunoz-Garcia, M.D.
000069782 700__ $$aMinguez-Gonzalo, P.
000069782 700__ $$aAraujo, L.
000069782 700__ $$aPalao, D.
000069782 700__ $$aGomez, M.C.
000069782 700__ $$aZubiaga, F.
000069782 700__ $$aNavas-Campana, D.
000069782 700__ $$aAranda-Regules, J.M.
000069782 700__ $$aRodriguez-Morejon, A.
000069782 700__ $$aLuna, J.D.
000069782 700__ $$aBellon, J.A.
000069782 773__ $$g16 (2018), 28$$pBMC Medicine$$tBMC Medicine$$x1741-7015
000069782 8564_ $$s922908$$uhttp://zaguan.unizar.es/record/69782/files/texto_completo.pdf$$yVersión publicada
000069782 8564_ $$s82039$$uhttp://zaguan.unizar.es/record/69782/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000069782 909CO $$ooai:zaguan.unizar.es:69782$$particulos$$pdriver
000069782 951__ $$a2018-04-13-10:29:14
000069782 980__ $$aARTICLE