Evidence map›Paper›PMID 15671185›Full record

Trial reportAnnals of family medicine

Cost-effectiveness of enhancing primary care depression management on an ongoing basis.

Kathryn Rost, Jeffrey M Pyne, L Miriam Dickinson, Anthony T LoSasso

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Annals of family medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
39citing papers in PubMed, 8 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

39 citing papers in PubMed, 8 syntheses or guidelines pooled it.

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  4. Collaborative care for depression and anxiety problems.The Cochrane database of systematic reviews · 2012
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  13. Stakeholder benefit from depression disease management: differences by rurality?The journal of behavioral health services & research · 2011
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Kathryn RostUniversity of Colorado, Health Sciences Center, Department of Family Medicine, UCHSC at Fitzsimons, PO Box 6508, Mail Stop F496, Aurora, CO 80045-0508, USA. Kathryn.Rost@UCHSC.edu
Jeffrey M Pyne
L Miriam Dickinson
Anthony T LoSasso

Funding

Influencing Employer Benefit Purchasing BehaviorR01MH076277 · NIMH · UNIVERSITY OF SOUTH FLORIDA · PI ROST, KATHRYN M · 2009 to 2013
$2.6M
QUALITY IMPROVEMENT FOR DEPRESSIONR01MH054444 · NIMH · UNIVERSITY OF COLORADO DENVER · PI ROST, KATHRYN M · 1998 to 2002
$784k
DEPRESSION TREATMENT QUALITY INDICATORS FOR EMPLOYER USEK02MH063651 · NIMH · UNIVERSITY OF COLORADO DENVER · PI ROST, KATHRYN M · 2001 to 2005
$662k
DEPRESSION GUIDELINES--OUTCOMES AND COSTS OF CAREU01MH054444 · NIMH · UNIVERSITY OF ARKANSAS MED SCIS LTL ROCK · PI ROST, KATHRYN M · 1994 to 1996
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NIMH NIH HHS K02 MH063651NIMH NIH HHS MH54444NIMH NIH HHS MH63651NIMH NIH HHS R01 MH054444NIMH NIH HHS R01 MH076277
6 · The paper itself

Abstract

purposeAlthough potentially costly, enhancing primary care depression management on an ongoing basis results in substantial long-term treatment effectiveness. The purpose of this article is to compare the cost-effectiveness of this approach with that of usual care.

methodsThe study was conducted in 12 community primary care practices randomized to enhanced or usual care after stratification by baseline practice patterns. Practices assigned to enhanced care encouraged depressed patients to engage in active treatment, using practice nurses to provide regularly scheduled care management during the course of 24 months. We analyze outcomes for 211 adults (73.4% of potential eligible patients) beginning a new treatment episode for major depression determined by previsit screening. Outcomes included blinded estimates of days free of depression impairment as well as health care costs for 2 years.

resultsEnhanced care significantly increased the number of days free of depression impairment for 2 years when compared with usual care (647.6 days vs 588.2 days, P <.01). The incremental cost-effectiveness ratio for enhanced care ranged from 9,592 dollars to 14,306 dollars per quality-adjusted life-year (QALY). The number of incremental days free of depression impairment increased between the first year and the second year (23.0 vs 36.4, respectively, P <.001) while incremental health plan costs decreased significantly (568 dollars vs -12 dollars, P <.001).

conclusionsEnhancing primary care depression management on an ongoing basis should be considered for adoption by policy and health plan leaders.

Indexed as

AdultCost-Benefit AnalysisDepressionFemaleHumansMalePrimary Health Care

Identifiers

PMID15671185
PMCPMC1350977

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.