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Care pathways for depression and anxiety

Study: Hakkaart-Van Roijen et al. (2006) Cost-utility of brief psychological treatment for depression and anxiety. British Journal of Psychiatry, 188, 323–329.
Economic Question: Brief therapy versus and CBT versus care as usual for depression and anxiety
Section 1: Applicability (relevance to specific guideline review question and the NICE reference case)Yes/ Partly/ No/Unclear/NAComments
1.1Is the study population appropriate for the guideline?YesPatients with DSM-IV diagnoses of major depressive disorder, dysthymic disorder, panic disorder, social phobia and GAD
1.2Are the interventions appropriate for the guideline?PartlyUsual care in The Netheralands
1.3Is the healthcare system in which the study was conducted sufficiently similar to the current UK NHS context?PartlyThe Netherlands – public funded system but standard care may differ
1.4Are costs measured from the NHS and personal social services (PSS) perspective?PartlyDirect healthcare costs and productivity losses due to absenteeism from work
1.5Are all direct health effects on individuals included?Yes
1.6Are both costs and health effects discounted at an annual rate of 3.5%?NATime horizon 18 months
1.7Is the value of health effects expressed in terms of quality-adjusted life years (QALYs)?Yes
1.8Are changes in health-related quality of life (HRQoL) reported directly from patients and/or carers?YesPatients' responses to EQ-5D questionnaire
1.9Is the valuation of changes in HRQoL (utilities) obtained from a representative sample of the general public?NoDutch weightings
1.10 Overall judgement: Not applicable
Other comments: Brief therapy in The Netherlands is defined as a formalised ‘stepped-care’ approach that focuses mainly on the present and on abilities instead of disabilities. Usual care in the Netherlands is not formalised and a multidisciplinary team can choose therapy from a wide variety of treatment options. The number of sessions depends on the therapy that is offered. Utility weights taken from Dutch population.


Cover of Common Mental Health Disorders
Common Mental Health Disorders: Identification and Pathways to Care.
NICE Clinical Guidelines, No. 123.
National Collaborating Centre for Mental Health (UK).
Leicester (UK): British Psychological Society; 2011.
Copyright © 2011, The British Psychological Society & The Royal College of Psychiatrists.

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