Depression screening with patient-targeted feedback in cardiology: The cost-effectiveness of DEPSCREEN-INFO.
Open accessAbstract
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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Among chronic heart failure patients and their family caregivers, the prevalence of anxiety is 55.5% in patients and 50% in caregivers, and the prevalence of depression is 22-42% in patients and 23-47% in caregivers.
“Studies have shown a high prevalence of anxiety (patients: 55.5%; FCs: 50%) and depression (patients: 22–42%; FCs: 23–47%) among CHF patients and their FCs [27–30].”
From Effectiveness of a videoconferencing group-based dyad acceptance and commitment therapy on the quality of life of chronic heart failure patients and their family caregivers: A study protocol for a randomized controlled trial (2024) · cites this paper as [27]
The Introduction (page unavailable) reports that 21.5% of heart failure patients had clinically significant major depression, approximately the lower end of the claimed 22–42% patient range. It does not report the rest of that range or the stated anxiety and caregiver prevalence figures. (LLM, conf=0.82)
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Self-citation
- Authors
- Brettschneider, C., Kohlmann, S., Gierk, B., Löwe, B., & König, H.-H.
- Affiliations
- University Medical Center Hamburg-Eppendorf (DE)
- Schön Klinik Hamburg Eilbek (DE)
- Corresponding author
- Brettschneider, Christian
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2017-08-14
- Volume
- 12
- Issue
- 8
- Pages
- e0181021
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC5555702
- OpenAlex
- W2749319144
- Cited by
- 11
- References
- 38
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 3 · 2023: 1 · 2021: 1 · 2020: 4
- FWCI
- 1.97
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Bundesministerium für Bildung und Forschung (01GX1004)
- Topics
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- depression screening, cost-effectiveness, coronary artery disease, hypertension, PHQ-9, quality-adjusted life years, EQ-5D, cardiac patients
- MeSH terms
- Adult, Aged, Cardiology, Cost-Benefit Analysis, Depression, Feedback, Female, Follow-Up Studies, Humans, Male, Mass Screening, Middle Aged, Patient Acceptance of Health Care, Quality of Life, Quality-Adjusted Life Years
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