Antonia Raya-Tena , María Isabel Fernández-San-Martín , Jaume Martín-Royo , Marc Casajuana-Closas , María Francisca Jiménez-Herrera
{"title":"针对基层医疗机构中抑郁症和躯体并发症患者的心理教育小组干预的成本效益和成本效用","authors":"Antonia Raya-Tena , María Isabel Fernández-San-Martín , Jaume Martín-Royo , Marc Casajuana-Closas , María Francisca Jiménez-Herrera","doi":"10.1016/j.enfcli.2023.12.001","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>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.</p></div><div><h3>Design</h3><p>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. <em>Location:</em> 27 PC teams from Catalonia. <em>Participants:</em> ><!--> <!-->50<!--> <!-->year-old patients with depression and some physical comorbidity: diabetes mellitus type<!--> <!-->2, ischemic heart disease, chronic obstructive pulmonary disease, and/or asthma. <em>Intervention:</em> 12 psychoeducational group sessions, 1 per week, led by 2 PC nurses with prior training.</p></div><div><h3>Measurements</h3><p><em>Effectiveness:</em> depression-free days (DFD) calculated from the BDI-II and quality-adjusted life years (QALYs) from the Euroqol-5D. <em>Direct costs:</em> PC visits, mental health, emergencies and hospitalizations, drugs. <em>Indirect costs:</em> days of temporary disability (TD). The incremental cost-effectiveness ratios (ICER), cost-effectiveness (ΔCost/ΔDLD) and cost-utility (ΔCost/ΔQALY) were estimated.</p></div><div><h3>Results</h3><p>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.</p></div><div><h3>Conclusions</h3><p>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.</p></div>","PeriodicalId":46453,"journal":{"name":"Enfermeria Clinica","volume":null,"pages":null},"PeriodicalIF":0.7000,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Coste-efectividad y coste-utilidad de una intervención grupal psicoeducativa para personas con depresión y comorbilidad física en atención primaria\",\"authors\":\"Antonia Raya-Tena , María Isabel Fernández-San-Martín , Jaume Martín-Royo , Marc Casajuana-Closas , María Francisca Jiménez-Herrera\",\"doi\":\"10.1016/j.enfcli.2023.12.001\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><p>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.</p></div><div><h3>Design</h3><p>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. <em>Location:</em> 27 PC teams from Catalonia. <em>Participants:</em> ><!--> <!-->50<!--> <!-->year-old patients with depression and some physical comorbidity: diabetes mellitus type<!--> <!-->2, ischemic heart disease, chronic obstructive pulmonary disease, and/or asthma. <em>Intervention:</em> 12 psychoeducational group sessions, 1 per week, led by 2 PC nurses with prior training.</p></div><div><h3>Measurements</h3><p><em>Effectiveness:</em> depression-free days (DFD) calculated from the BDI-II and quality-adjusted life years (QALYs) from the Euroqol-5D. <em>Direct costs:</em> PC visits, mental health, emergencies and hospitalizations, drugs. <em>Indirect costs:</em> days of temporary disability (TD). The incremental cost-effectiveness ratios (ICER), cost-effectiveness (ΔCost/ΔDLD) and cost-utility (ΔCost/ΔQALY) were estimated.</p></div><div><h3>Results</h3><p>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.</p></div><div><h3>Conclusions</h3><p>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.</p></div>\",\"PeriodicalId\":46453,\"journal\":{\"name\":\"Enfermeria Clinica\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.7000,\"publicationDate\":\"2024-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Enfermeria Clinica\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1130862123001523\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"NURSING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Enfermeria Clinica","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1130862123001523","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"NURSING","Score":null,"Total":0}
Coste-efectividad y coste-utilidad de una intervención grupal psicoeducativa para personas con depresión y comorbilidad física en atención primaria
Objective
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.
Design
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. Location: 27 PC teams from Catalonia. Participants: > 50 year-old patients with depression and some physical comorbidity: diabetes mellitus type 2, ischemic heart disease, chronic obstructive pulmonary disease, and/or asthma. Intervention: 12 psychoeducational group sessions, 1 per week, led by 2 PC nurses with prior training.
Measurements
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.
Results
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.
Conclusions
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.
期刊介绍：
Enfermería Clínica is a peer-reviewed scientific journal that is a useful and necessary tool for nursing professionals from the different areas of nursing (healthcare, administration, education and research) as well as for healthcare professionals involved in caring for persons, families and the community. It is the only Spanish nursing journal that mainly publishes original research. The aim of the Journal is to promote increased knowledge through the publication of original research and other studies that may help nursing professionals improve their daily practice. This objective is pursued throughout the different sections that comprise the Journal: Original Articles and Short Original Articles, Special Articles, Patient Care and Letters to the Editor. There is also an Evidence-Based Nursing section that includes comments about original articles of special interest written by experts.
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