Department of General Practice, Institute for Research in Extramural Medicine, VU Medical Centre, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands.
Br J Psychiatry. 2010 Apr;196(4):319-25. doi: 10.1192/bjp.bp.109.069617.
There is an urgent need for the development of cost-effective preventive strategies to reduce the onset of mental disorders.
To establish the cost-effectiveness of a stepped care preventive intervention for depression and anxiety disorders in older people at high risk of these conditions, compared with routine primary care.
An economic evaluation was conducted alongside a pragmatic randomised controlled trial (ISRCTN26474556). Consenting individuals presenting with subthreshold levels of depressive or anxiety symptoms were randomly assigned to a preventive stepped care programme (n = 86) or to routine primary care (n = 84).
The intervention was successful in halving the incidence rate of depression and anxiety at euro563 ( pound412) per recipient and euro4367 ( pound3196) per disorder-free year gained, compared with routine primary care. The latter would represent good value for money if the willingness to pay for a disorder-free year is at least euro5000.
The prevention programme generated depression- and anxiety-free survival years in the older population at affordable cost.
迫切需要开发具有成本效益的预防策略，以减少精神障碍的发生。
评估针对有患病高风险的老年人的抑郁和焦虑障碍的阶梯式护理预防干预措施与常规初级保健相比的成本效益。
在一项实用随机对照试验（ISRCTN26474556）中进行了经济评估。同意参加的个体表现出亚临床水平的抑郁或焦虑症状，被随机分配到预防阶梯式护理计划（n = 86）或常规初级保健（n = 84）。
与常规初级保健相比，干预措施成功地将抑郁和焦虑的发生率降低了一半，每接受者花费 563 欧元（412 英镑），每获得一个无疾病的年度花费 4367 欧元（3196 英镑）。如果无疾病一年的意愿支付至少为 5000 欧元，那么这种干预措施将具有良好的性价比。
该预防计划以可负担的成本为老年人群体创造了无抑郁和焦虑的生存年限。
