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Accepted (AM)Open Access (License Unspecified), Open
Journal article
Cost-Effectiveness of a Community-Integrated Home-Based Depression Intervention in Older African Americans
Journal of the American Geriatrics Society (JAGS), v 62(12), pp 2288-2295
01 Dec 2014
PMID: 25516025
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
ObjectivesTo test the cost-effectiveness of a home-based depression program: Beat the Blues (BTB).
DesignA cost-effectiveness analysis as part of a previously reported randomized controlled trial that compared BTB with a wait-list control group.
SettingCommunity.
ParticipantsEnglish-speaking, cognitively intact (Mini-Mental State Examination score 24), African Americans aged 55 and older with depressive symptoms (Patient Health Questionnaire score 5) (N=129).
InterventionParticipants randomly assigned to BTB received up to 10 home visits over 4months from licensed social workers who provided care management, referral and linkage, stress reduction, depression education, and behavioral activation to help participants achieve self-identified goals.
MeasurementsIncremental cost-effectiveness ratios (ICERs) of BTB versus wait-list controls during the 4-month study period. The primary ICER was defined as cost per quality-adjusted life year (QALY) using the Euro Quality of Life 5D (EQ-5D) and secondarily using the Health Utilities Index-3 (HUI-3). Additional ICERs were calculated using clinical measures (cost per depression improvement, cost per depression remission). Costs included BTB intervention, depression-related healthcare visits and medications, caregiver time, and social services.
ResultsBTB cost per participant per month was $146. Base case ICERs were $64,896 per QALY (EQ-5D) and $36,875 per QALY (HUI-3). Incremental cost was $2,906 per depression improvement and $3,507 per remission. Univariate and probabilistic sensitivity analyses yielded a cost/QALY range of $20,500 to $76,500.
ConclusionBased on the range of cost-effectiveness values resulting from this study, BTB is a cost-effective treatment for managing depressive symptoms in older African Americans that compares favorably with the cost-effectiveness of previously tested approaches.
Metrics
Details
- Title
- Cost-Effectiveness of a Community-Integrated Home-Based Depression Intervention in Older African Americans
- Creators
- Laura T. Pizzi - Thomas Jefferson UniversityEric Jutkowitz - University of MinnesotaKevin D. Frick - Johns Hopkins UniversityDong-Churl Suh - Chung-Ang UniversityKatherine M. Prioli - Thomas Jefferson UniversityLaura N. Gitlin - Johns Hopkins University
- Publication Details
- Journal of the American Geriatrics Society (JAGS), v 62(12), pp 2288-2295
- Publisher
- Wiley
- Number of pages
- 8
- Grant note
- RO1 MH 079814; RC1MH09077 / National Institute of Mental Health; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Mental Health (NIMH) Hearst Foundation R01MH079814 / NATIONAL INSTITUTE OF MENTAL HEALTH; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Mental Health (NIMH) Agency for Health Research and Quality National Research Service Award Traineeship
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- College of Nursing and Health Professions; Drexel University
- Web of Science ID
- WOS:000346497600007
- Scopus ID
- 2-s2.0-84918813099
- Other Identifier
- 991020111921404721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Geriatrics & Gerontology
- Gerontology