Web-based intervention for depressive symptoms in adults with types 1 and 2 diabetes mellitus: a health economic evaluation
Open accessAbstract
Background: Web-based interventions are effective in reducing depression. However, the evidence for the cost-effectiveness of these interventions is scarce. Aims: The aim is to assess the cost-effectiveness of a web-based intervention (GET.ON M.E.D.) for individuals with diabetes and comorbid depression compared with an active control group receiving web-based psychoeducation. Method: We conducted a cost-effectiveness analysis with treatment response as the outcome and a cost-utility analysis with quality-adjusted life-years (QALYs) alongside a randomised controlled trial with 260 participants. Results: At a willingness-to-pay ceiling of €5000 for a treatment response, the intervention has a 97% probability of being regarded as cost-effective compared with the active control group. If society is willing to pay €14 000 for an additional QALY, the intervention has a 51% probability of being cost-effective. Conclusions: This web-based intervention for individuals with diabetes and comorbid depression demonstrated a high probability of being cost-effective compared with an active control group. Declaration of interest: S.N., D.D.E., D.L., M.B. and B.F. are stakeholders of the Institute for Online Health Trainings, which aims to transfer scientific knowledge related to this research into routine healthcare.
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Scalability is one of the main arguments for implementation of telehealth compared to face-to-face services, but different delivery modes are also associated with varying costs and time investment from health care professionals posing a potential bottleneck in care distribution.
“Scalability is one of the main arguments for implementation of telehealth compared to face-to-face services, but different delivery modes are also associated with varying costs and time investment from health care professionals (e.g., one-on-one coaching vs. unguided internet-based intervention) posing a potential bottleneck in care distribution (Berryhill et al., 2019; Nobis et al., 2018).”
From How to promote usage of telehealth interventions for farmers' mental health? A qualitative study on supporting and hindering aspects for acceptance and satisfaction with a personalized telephone coaching for depression prevention (2023) · cites this paper as Nobis et al., 2018
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Experimental — accuracy not yet measuredDigital depression interventions can work for people with diabetes.
“As one example, Bendig et al. (2021) reported on a failed trial examining an intervention for depression in people with coronary artery disease, while we do know that this kind of intervention can work e.g. for people with diabetes (Nobis et al., 2018; Nobis et al., 2015; van Bastelaar et al., 2008).”
From Special issue on digital health interventions in chronic medical conditions: Editorial (2022) · cites this paper as Nobis et al., 2018
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“…services, but different delivery modes are also associated with varying costs and time investment from health care professionals (e.g., one-on-one coaching vs. unguided internet-based intervention) posing a potential bottleneck in care distribution (Berryhill et al., 2019; Nobis et al., 2018).”
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Self-citation
- Authors
- Nobis, S., Ebert, D. D., Lehr, D., Smit, F., Buntrock, C., Berking, M., Baumeister, H., Snoek, F., Funk, B., & Riper, H.
- Affiliations
- Leuphana University of Lüneburg (DE)
- Trimbos Institute (NL)
- Universität Ulm (DE)
- Amsterdam UMC Location University of Amsterdam (NL)
- Corresponding author
- Nobis, Stephanie
- ORCID
- Venue
- The British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2018-03-04
- Volume
- 212
- Issue
- 4
- Pages
- 199-206
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- OpenAlex
- W2789876302
- Cited by
- 43
- References
- 42
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 4 · 2023: 7 · 2022: 9 · 2021: 5 · 2020: 7 · 2019: 6 · 2018: 1 · 2017: 1
- FWCI
- 5.99
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion, other-oa)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- Multilingual Matters (Channel View Publications) (publishedVersion, other-oa)
- University of Southern Denmark Research Portal (University of Southern Denmark) (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- VU Research Portal (submittedVersion, other-oa)
- Funders
- European Commission (2007DE161PR001, ZW6‐80119999, CCI 2007DE161PR001, EFRE: ZW6-80119999, CCI 2007DE161PR001)
- European Regional Development Fund (ZW6-80119999, CCI 2007DE161PR001, 2007DE161PR001)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- online intervention, depression, diabetes mellitus, type 1 diabetes, type 2 diabetes, comorbid depression, cost-effectiveness, cost-utility analysis, quality-adjusted life years, psychoeducation, digital mental health interventions
- MeSH terms
- Adult, Cost-Benefit Analysis, Depression, Depressive Disorder, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Female, Humans, Male, Middle Aged, Comorbidity, Cognitive Behavioral Therapy, Outcome Assessment, Health Care, Telemedicine, Quality-Adjusted Life Years, Internet
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