Evidence map›Paper›PMID 36253766›Full record

Trial reportBMC psychiatry2022

Cost-effectiveness of Tele-delivered behavioral activation by Lay counselors for homebound older adults with depression.

Guoqing John Chen, Mark E Kunik, C Nathan Marti, Namkee G Choi

2 registry-linked trialsAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC psychiatry, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–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.

NCT02600754 nacompletednot on this map

Telehealth Treatments for Depression With Low-Income Homebound Seniors

TypeinterventionalSponsorUniversity of Texas at AustinRan2016 to 2020Enrolled277ConditionsDepressionArmsIT-PST, IT-SCM
NCT04041375 nacompletednot on this map

Using Peer Navigators to Increase Access to VA and Community Resources for Veterans With Diabetes-related Distress

TypeinterventionalSponsorVA Office of Research and DevelopmentRan2019 to 2022Enrolled219ConditionsDiabetesArmsiNSPiRED, Usual Care
3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Review
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.

Guoqing John ChenUniversity of Kanas Medical Center, Kansas City, KS, USA. gchen2@kumc.edu.
Mark E KunikHSR&D Center for Innovations in Quality, Effectiveness and Safety, Baylor College of Medicine, Michael E. DeBakey VA Medical Center, Houston, Houston, VA, TX, USA.
C Nathan MartiSteve Hicks School of Social Work, University of Texas at Austin, Austin, TX, USA.
Namkee G ChoiSteve Hicks School of Social Work, University of Texas at Austin, Austin, TX, USA.

Funding

Telehealth Treatments for Depression with Low-Income Homebound SeniorsR01MD009675 · NIMHD · UNIVERSITY OF TEXAS AT AUSTIN · PI CHOI, NAMKEE G · 2015 to 2025
$5.3M
NIMHD NIH HHS R01 MD009675
6 · The paper itself

Abstract

backgroundLow-income homebound older adults have limited access to psychosocial treatments because of their homebound state and geriatric mental health workforce shortages. Little is known about cost effectiveness of lay-counselor-delivered, videoconferenced, short-term behavioral activation on this study population. The objective of this study was to assess the cost-effectiveness of lay-counselor-delivered, videoconferenced, short-term behavioral activation (Tele-BA) compared to clinician-delivered, videoconferenced problem-solving therapy (Tele-PST) and telephone support calls (attention control; AC) for low-income homebound older adults.

methodsWe performed a cost-effectiveness analysis based on data from a recently completed, 3-group (Tele-BA, Tele-PST, and AC) randomized controlled trial with 277 participants aged 50+. We measured total costs of (1) intervention and (2) outpatient care, ED visits, and inpatient care using the Cornell Services Index. The effectiveness outcome was quality-adjusted life-years (QALY). We used EuroQol's EQ-5D-5L to assess each participant's health-related quality of life (HRQoL) at baseline and at 12, 24, and 36 weeks. The end-point measure of cost-effectiveness was the incremental cost-effectiveness ratio (ICER) of (1) Tele-BA versus AC, (2) Tele-PST versus AC, and (3) Tele-BA versus Tele-PST.

resultsRelative to AC, both Tele-BA and Tele-PST are cost-saving treatment options. The ICERs for both Tele-BA and Tele-PST were well below $50,000, the lower-bound threshold for cost-effectiveness. Relative to AC, both Tele-PST, Tele-BA are cost-saving treatment options (i.e. lower costs and more QALYs).

conclusionCosts of tele- and lay-counselor-delivered depression treatment are modest and cost effective relative to providing telephone support. Though our results show that Tele-BA may not be cost effective relative to Tele-PST, a clinician-delivered psychotherapy, when a low bound ICER threshold of $50,000 would be used, lay counselors can fill the professional geriatric mental health workforce shortage gap and Tele-BA by lay counselors can improve homebound older adults' access to evidence-and skills-based, cost effective depression care.

trial registrationClinicalTrials.gov identifier: NCT02600754 (11/09/2015).

Indexed as

CounselorsAgedCost-Benefit AnalysisDepressionHumansQuality of LifeTreatment OutcomeBehavioral activationCost-effectivenessDepressionIncremental cost-effectiveness ratioLay counselorsProblem-solving therapy

Identifiers

PMID36253766
PMCPMC9574809

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

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.