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Centre for Policy on Ageing | |
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Effects of a stepped-care intervention programme among older subjects who screened positive for depressive symptoms in general practice
— the PROMODE randomised controlled trial | | Author(s) | Gerda M van der Weele, Margot W M de Waal, Wilbert B van den Hout |
| Journal title | Age and Ageing, vol 41, no 4, July 2012 |
| Pages | pp 482-488 |
| Source | http://ageing.oxfordjournals.org/ http://www.bgs.org.uk/ |
| Keywords | Depression ; Screening ; General practice ; Medical care ; Therapeutics ; Clinical surveys ; Usage [services] ; Cost effectiveness ; Netherlands. |
| Annotation | This Dutch study aimed to determine the cost-effectiveness of a stepped-care intervention programme among subjects aged 75 years or over who screened positive for depressive symptoms in general practice. Programme design consisted of a cluster-randomised controlled trial with12-month follow-up. 239 study participants screened positive for untreated depressive symptoms. Usual care was then compared with the stepped-care intervention consisting of three steps: individual counselling, Coping with Depression course and - if indicated - referral back to general practitioner to discuss further treatment. Measurements included severity of depressive symptoms using the Montgomery-Åsberg Depression Rating Scale (MADRS), quality of life, mortality and costs. Study results showed that at baseline subjects mostly were mildly or moderately depressed. At six months MADRS scores had improved more in the usual care than the intervention group but not at 12 months. No significant differences were found within two separate age groups (75-79 years and 80 years or over). In intervention practices, 83% accepted referral to the stepped-care programme, and 19% accepted course participation. The control group appeared to have received more psychological care. Among older subjects who screened positive for depressive symptoms, an offered stepped-care intervention programme was not cost-effective compared with usual care, possibly due to a low uptake of the course offer. (JL). |
| Accession Number | CPA-120814006 A |
| Classmark | ENR: 3V: L5: LK: LL: 3G: QLD: WEC: 76H |
Data © Centre for Policy on Ageing |
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| ...from the Ageinfo database published by Centre for Policy on Ageing. |
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