Gräfe Viola, Berger Thomas, Hautzinger Martin, Hohagen Fritz, Lutz Wolfgang, Meyer Björn, Moritz Steffen, Rose Matthias, Schröder Johanna, Späth Christina, Klein Jan Philipp, Greiner Wolfgang
Department of Health Economics and Health Care Management, School of Public Health, Bielefeld University, Universitätsstraße 25, 33615, Bielefeld, Germany.
Department of Clinical Psychology and Psychotherapy, University of Bern, Hochschulstrasse 6, 3012, Bern, Switzerland.
Health Econ Rev. 2019 Jun 7;9(1):16. doi: 10.1186/s13561-019-0233-y.
Depression often remains undiagnosed or treated inadequately. Web-based interventions for depression may improve accessibility of treatment and reduce disease-related costs. This study aimed to examine the potential of the web-based cognitive behavioral intervention "deprexis" in reducing disease-related costs.
Participants with mild to moderate depressive symptoms were recruited and randomized to either a 12-week web-based intervention (deprexis) in addition to care as usual (intervention group) or care as usual (control group). Outcome measures were health-related resource use, use of medication and incapacity to work as well as relating direct health care costs. Outcomes were assessed on patients' self-report at baseline, three months and six months.
A total of 1013 participants were randomized. In both groups total direct health care costs decreased during the study period, but changes from baseline did not significantly differ between study groups. Numeric differences between study groups existed in outpatient treatment costs. They could be attributed to differences in changes of costs for psychotherapeutic treatment from baseline. Whereas costs for psychotherapeutic treatment decreased in the intervention group, costs increased in the control group (- 16.8% (€80) vs. + 14.7% (€60)) (t = 2.57; p = 0.008).
The study indicates the health economic potential of innovative e-mental-health programs. There is evidence to suggest that the use of deprexis over a period of 12 weeks leads to a decrease in outpatient treatment cost, especially in those related to different types of psychotherapeutic treatment.
抑郁症常常未被诊断或治疗不充分。基于网络的抑郁症干预措施可能会提高治疗的可及性并降低疾病相关成本。本研究旨在探讨基于网络的认知行为干预“deprexis”在降低疾病相关成本方面的潜力。
招募有轻度至中度抑郁症状的参与者，并将其随机分为两组，一组除接受常规护理外还接受为期12周的基于网络的干预（干预组），另一组仅接受常规护理（对照组）。结果指标包括与健康相关的资源使用、药物使用、工作能力丧失情况以及直接医疗保健成本。在基线、三个月和六个月时通过患者自我报告评估结果。
共有1013名参与者被随机分组。在研究期间，两组的直接医疗保健总成本均有所下降，但研究组之间与基线相比的变化无显著差异。研究组之间在门诊治疗成本上存在数值差异。这可归因于心理治疗成本相对于基线的变化差异。干预组的心理治疗成本下降，而对照组的成本上升（-16.8%（80欧元）对+14.7%（60欧元））（t = 2.57；p = 0.008）。
该研究表明了创新性电子心理健康项目的健康经济潜力。有证据表明，在12周的时间内使用deprexis可降低门诊治疗成本，尤其是与不同类型心理治疗相关的成本。
