Cost-Effectiveness of a Web-Based Program for Residual Depressive Symptoms: Mindful Mood Balance.
Cost-Effectiveness of a Web-Based Program for Residual Depressive Symptoms: Mindful Mood Balance.
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用于残留抑郁症状的基于Web的程序的成本效益：正念情绪平衡。
DOI：
10.1176/appi.ps.202000419
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发表时间：
2022-02-01
期刊：
影响因子：
--
通讯作者：
Segal ZV
中科院分区：
文献类型：
--
作者：
Boggs JM;Ritzwoller DP;Beck A;Dimidjian S;Segal ZV
正念情绪平衡 (MMB) 是一种有效的基于网络的残留抑郁症状计划，可防止从重度抑郁发作部分恢复的患者重度抑郁复发。这是从健康计划角度进行的成本效益分析以及 MMB 的实用随机对照试验。在大型综合卫生系统的行为健康和初级保健机构中招募成年患者并随机分配至 MMB + 常规抑郁症护理或常规抑郁症护理 (UCD)。患者既往有≥1次重度抑郁发作，当前 PHQ-9 评分为 5-9 分（表明残留抑郁症状），并且能够上网。项目成本包括招聘、辅导和 MMB 许可。医疗保险和医疗补助中心费用表适用于所有精神药物、精神科和心理治疗就诊的 EHR 使用。有效性以无抑郁日来衡量，根据 1 年随访期间每月收集的 PHQ-9 分数进行转换。增量成本效益比是通过不同的成本投入集来计算的。共有 389 名患者（210 名 UCD 和 179 名 MMB+UDC）接受了超过 12 个月的充分随访 PHQ-9 测量。在 12 个月的随访期间，MMB 患者的抑郁天数增加了 28 天。总体而言，12 个月内 MMB+UDC 的增量成本为 431.54 美元。每个无抑郁症日增加的成本范围从仅计划成本 9.63 美元到包括精神病就诊、心理治疗就诊和精神药物在内的 15.04 美元不等。 MMB 提供了一个经济有效的基于网络的计划，用于减少残留抑郁症状并防止重度抑郁复发，卫生系统应考虑采用该计划作为传统精神卫生保健服务的辅助手段。
Mindful Mood Balance (MMB) is an effective web-based program for residual depressive symptoms that prevents major depressive relapse among patients who partially recovered from major depressive episodes. This is a cost-effectiveness analysis from the health plan perspective alongside a pragmatic randomized controlled trial of MMB. Adult patients were recruited and randomized to MMB + Usual Depression Care or Usual Depression Care (UCD) from behavioral health and primary care settings in a large integrated health system. Patients had >=1 prior major depressive episode, current PHQ-9 score of 5–9 indicating residual depressive symptoms, and internet access. Program costs included recruitment, coaching and MMB licensing. Center for Medicare and Medicaid fee schedules were applied to EHR utilization for all psychotropic medications, psychiatric and psychotherapy visits. Effectiveness was measured as Depression Free Days, converted from PHQ-9 scores collected every month during 1-year follow-up. Incremental Cost Effectiveness Ratios were calculated with different sets of cost-inputs. There were 389 patients (210 UCD and 179 MMB+UDC) included with adequate follow-up PHQ-9 measures over 12 months. MMB patients had 28 more depression free days during the 12-month follow-up period. Overall, the incremental cost of MMB+UDC was $431.54 over 12-months. Incremental costs per depression free day gained ranged from $9.63 for program costs only to $15.04 when psychiatric visits, psychotherapy visits and psychotropic medications were included. MMB offers a cost-effective web-based program for reducing residual depressive symptoms and preventing major depressive relapse that health systems should consider adopting as adjunctive to traditional mental health care services.
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影响因子：
7.4
作者：
Boggs JM;Beck A;Felder JN;Dimidjian S;Metcalf CA;Segal ZV
通讯作者：
Segal ZV
预防阈下抑郁症成人的抑郁症：健康经济学评估以及基于网络干预的务实随机对照试验。
影响因子：
7.4
作者：
Buntrock C;Berking M;Smit F;Lehr D;Nobis S;Riper H;Cuijpers P;Ebert D
通讯作者：
Ebert D
DOI：
10.1001/jama.2017.3826
发表时间：
2017-04-18
期刊：
JAMA
影响因子：
--
作者：
Friedrich, M J
通讯作者：
Friedrich, M J
影响因子：
10.5
作者：
McCrone, P;Knapp, M;Tylee, A
通讯作者：
Tylee, A
影响因子：
6.1
作者：
McTernan, Wesley P.;Dollard, Maureen F.;LaMontagne, Anthony D.
通讯作者：
LaMontagne, Anthony D.