King's College London, Institute of Psychiatry, United Kingdom.
J Affect Disord. 2011 Feb;128(3):211-9. doi: 10.1016/j.jad.2010.07.026. Epub 2010 Aug 8.
For older people who have had hip fracture surgery, to evaluate the cost-effectiveness of a nurse-led intervention in treating depression compared to treatment as usual (TAU), and to evaluate the cost-effectiveness of a psychological treatment for the prevention of depression.
Two linked cost-effectiveness studies for the treatment and prevention of depression after hip surgery, from the perspective of health, social care, voluntary sector agencies and unpaid carers.
Orthopaedic units in Manchester, England.
One hundred and twenty-one patients with Geriatric Depression Scale (GDS) scores greater than 6 were included in the treatment study and 172 patients with GDS scores less than or equal to 6 were enrolled in the prevention study.
Nurse-led intervention for treating depression versus TAU; and cognitive behaviour therapy (CBT) for preventing depression following surgery for hip fracture.
Outcomes were changes in HADS-depression scores at 6 weeks. Costs covered treatment and all service impacts.
After 6 weeks, there were no significant differences in cost. However, the nurse-led intervention group had a lower mean HADS-depression score compared to TAU. In the prevention study, there were no significant differences in cost and depression score between patients treated with CBT and TAU.
The results for this parallel randomized controlled study show that after hip fracture surgery a nurse-led intervention may be a cost-effective option for the treatment of depression in older people with depression. However CBT does not appear to be a cost-effective option for the prevention of depression in this population.
对于接受髋关节骨折手术的老年人，评估护士主导的干预治疗与常规治疗（TAU）相比治疗抑郁症的成本效益，并评估心理治疗预防抑郁症的成本效益。
从健康、社会护理、志愿部门机构和无报酬护理人员的角度出发，对髋关节手术后治疗和预防抑郁症的两项相关成本效益研究。
英国曼彻斯特的骨科病房。
121 名老年抑郁量表（GDS）评分大于 6 的患者被纳入治疗研究，172 名 GDS 评分小于或等于 6 的患者被纳入预防研究。
护士主导的干预治疗抑郁症与 TAU；认知行为疗法（CBT）预防髋关节手术后抑郁症。
6 周时 HADS 抑郁评分的变化。成本涵盖治疗和所有服务影响。
6 周后，成本没有显著差异。然而，与 TAU 相比，护士主导的干预组 HADS 抑郁评分较低。在预防研究中，接受 CBT 和 TAU 治疗的患者在成本和抑郁评分方面没有显著差异。
这项平行随机对照研究的结果表明，髋关节骨折手术后，护士主导的干预可能是治疗老年抑郁症患者抑郁症的一种具有成本效益的选择。然而，CBT 似乎不是预防该人群抑郁症的一种具有成本效益的选择。
