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J Affect Disord. 2011 Feb;128(3):211-9. doi: 10.1016/j.jad.2010.07.026. Epub 2010 Aug 8.

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

Author information

1
King's College London, Institute of Psychiatry, United Kingdom. renee.romeo@kcl.ac.uk

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.

PMID:
20696480
DOI:
10.1016/j.jad.2010.07.026
[Indexed for MEDLINE]

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