TY - JOUR
T1 - Cost-effectiveness of life-review for older adults with moderate depressive symptomatology: A pragmatic randomized controlled trial
AU - Korte, J.
AU - Majo, M.C.
AU - Bohlmeijer, E.T.
AU - Westerhof, G.J.
AU - Smit, H.F.E.
PY - 2015
Y1 - 2015
N2 - Purpose: Life-review has been established as an evidence-based treatment of depression in later life. This study investigates the cost-effectiveness of life-review compared to care-as-usual. Methods: An economic evaluation alongside a randomized controlled trial was carried out, comparing life-review (. n=. 100) to care-as-usual (. n=. 102). Individuals of 55. years and over, with moderate depressive symptomatology, were included. Treatment response was defined as a statistically reliable reduction of depressive symptoms on the Center for Epidemiologic Studies Depression scale. Total per-participant costs encompassed intervention costs, costs of receiving other treatments, participants' out-of-pocket expenses, and costs stemming from production losses, and were expressed in (2009) euros (€). Results: At 6-month follow-up, treatment response was 54.0% and 27.5% in the life-review and usual-care conditions, respectively. The difference in effectiveness was statistically significant at p=. .001 (2-tailed). In the respective conditions the costs were €5550 and €3162, with the higher costs in the intervention arm of the trial. The incremental cost-effectiveness was €8675 (US$10,227) per improved participant. Conclusion: The findings suggest that offering life-review rather than care-as-usual almost doubles the likelihood of a favorable outcome. However, the better clinical outcomes are achieved at greater costs. The conclusion that life-review offers good value for money is sensitive to the willingness to pay for a favorable treatment response. It is recommended that life-review is delivered by a single therapist and in larger groups as this may improve the cost-effectiveness of this intervention.
AB - Purpose: Life-review has been established as an evidence-based treatment of depression in later life. This study investigates the cost-effectiveness of life-review compared to care-as-usual. Methods: An economic evaluation alongside a randomized controlled trial was carried out, comparing life-review (. n=. 100) to care-as-usual (. n=. 102). Individuals of 55. years and over, with moderate depressive symptomatology, were included. Treatment response was defined as a statistically reliable reduction of depressive symptoms on the Center for Epidemiologic Studies Depression scale. Total per-participant costs encompassed intervention costs, costs of receiving other treatments, participants' out-of-pocket expenses, and costs stemming from production losses, and were expressed in (2009) euros (€). Results: At 6-month follow-up, treatment response was 54.0% and 27.5% in the life-review and usual-care conditions, respectively. The difference in effectiveness was statistically significant at p=. .001 (2-tailed). In the respective conditions the costs were €5550 and €3162, with the higher costs in the intervention arm of the trial. The incremental cost-effectiveness was €8675 (US$10,227) per improved participant. Conclusion: The findings suggest that offering life-review rather than care-as-usual almost doubles the likelihood of a favorable outcome. However, the better clinical outcomes are achieved at greater costs. The conclusion that life-review offers good value for money is sensitive to the willingness to pay for a favorable treatment response. It is recommended that life-review is delivered by a single therapist and in larger groups as this may improve the cost-effectiveness of this intervention.
U2 - https://doi.org/10.1016/j.jaging.2015.02.008
DO - https://doi.org/10.1016/j.jaging.2015.02.008
M3 - Article
C2 - 26162735
SN - 0890-4065
VL - 34
SP - 146
EP - 154
JO - Journal of Aging Studies
JF - Journal of Aging Studies
ER -
