Treatment and prevention of depression after surgery for hip fracture in older people: cost-effectiveness analysis

Romeo, Renee, Knapp, Martin, Banerjee, Sube, Morris, Julie, Baldwin, Robert, Tarrier, Nicholas, Pendleton, Neil, Horan, Mike and Burns, Alistair (2011) Treatment and prevention of depression after surgery for hip fracture in older people: cost-effectiveness analysis. Journal of Affective Disorders, 128 (3). pp. 211-219. ISSN 0165-0327

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Abstract

OBJECTIVE

For older people who have had hip fracture surgery, to evaluate the cost-effectiveness of a nurse-led intervention in treating depression compared to treatment as usual (TAU), and to evaluate the cost-effectiveness of a psychological treatment for the prevention of depression.

DESIGN

Two linked cost-effectiveness studies for the treatment and prevention of depression after hip surgery, from the perspective of health, social care, voluntary sector agencies and unpaid carers.

SETTING

Orthopaedic units in Manchester, England.

PARTICIPANTS

One hundred and twenty-one patients with Geriatric Depression Scale (GDS) scores greater than 6 were included in the treatment study and 172 patients with GDS scores less than or equal to 6 were enrolled in the prevention study.

INTERVENTIONS

Nurse-led intervention for treating depression versus TAU; and cognitive behaviour therapy (CBT) for preventing depression following surgery for hip fracture.

MAIN OUTCOME MEASURES

Outcomes were changes in HADS-depression scores at 6 weeks. Costs covered treatment and all service impacts.

RESULTS

After 6 weeks, there were no significant differences in cost. However, the nurse-led intervention group had a lower mean HADS-depression score compared to TAU. In the prevention study, there were no significant differences in cost and depression score between patients treated with CBT and TAU.

CONCLUSION

The results for this parallel randomized controlled study show that after hip fracture surgery a nurse-led intervention may be a cost-effective option for the treatment of depression in older people with depression. However CBT does not appear to be a cost-effective option for the prevention of depression in this population

Item Type: Article
Additional Information: Impact Factor: 3.517
Schools and Departments: Brighton and Sussex Medical School > Clinical and Experimental Medicine
Brighton and Sussex Medical School > Neuroscience
Subjects: R Medicine
Related URLs:
Depositing User: Patricia Butler
Date Deposited: 03 Dec 2012 18:57
Last Modified: 25 Sep 2017 11:36
URI: http://sro.sussex.ac.uk/id/eprint/43218
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