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

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.

journal_name

J Affect Disord

journal_title

Journal of affective disorders

authors

Romeo R,Knapp M,Banerjee S,Morris J,Baldwin R,Tarrier N,Pendleton N,Horan M,Burns A

doi

10.1016/j.jad.2010.07.026

subject

Has Abstract

pub_date

2011-02-01 00:00:00

pages

211-9

issue

3

eissn

0165-0327

issn

1573-2517

pii

S0165-0327(10)00507-0

journal_volume

128

pub_type

杂志文章,随机对照试验

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