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Depression screening with patient-targeted feedback in cardiology: The cost-effectiveness of DEPSCREEN-INFO

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  • Christian Brettschneider
  • Sebastian Kohlmann
  • Benjamin Gierk
  • Bernd Löwe
  • Hans-Helmut König

Abstract

Background: Although depression is common in patients with heart disease, screening for depression is much debated. DEPSCREEN-INFO showed that a patient-targeted feedback in addition to screening results in lower depression level six months after screening. The purpose of this analysis was to perform a cost-effectiveness analysis of DEPSCREEN-INFO. Methods: Patients with coronary heart disease or arterial hypertension were included. Participants in both groups were screened for depression. Participants in the intervention group additionally received a patient-targeted feedback of their result and recommended treatment options. A cost-utility analysis using quality-adjusted life years (QALY) based on the EQ-5D was performed. The time horizon was 6 months. Resource utilization was assessed by a telephone interview. Multiple imputation using chained equations was used. Net-benefit regressions controlled for prognostic variables at baseline were performed to construct cost-effectiveness acceptability curves. Different sensitivity analyses were performed. Results: 375 participants (intervention group: 155; control group: 220) were included at baseline. After 6 months, in the intervention group adjusted total costs were lower (-€2,098; SE: €1,717) and more QALY were gained (0.0067; SD: 0.0133); yet differences were not statistically significant. The probability of cost-effectiveness was around 80% independent of the willingness-to-pay (range: €0/QALY–€130,000/QALY). The results were robust. Conclusions: A patient-targeted feedback in addition to depression screening in cardiology is cost-effective with a high probability. This underpins the use of the patient-targeted feedbacks and the PHQ-9 that are both freely available and easy to implement in routine care.

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  • Christian Brettschneider & Sebastian Kohlmann & Benjamin Gierk & Bernd Löwe & Hans-Helmut König, 2017. "Depression screening with patient-targeted feedback in cardiology: The cost-effectiveness of DEPSCREEN-INFO," PLOS ONE, Public Library of Science, vol. 12(8), pages 1-15, August.
    • Handle: RePEc:plo:pone00:0181021
    DOI: 10.1371/journal.pone.0181021
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