Kigozi, J, Jowett, S, Nicholl, BI, Lewis, M, Bartlam, B, Green, D, Belcher, J, Clarkson, K, Lingard, Z, Pope, C, Chew-Graham, CA, Croft, P, Hay, EM ORCID: https://orcid.org/0000-0002-9545-4296, Peat, G ORCID: https://orcid.org/0000-0002-9008-0184 and Mallen, CD ORCID: https://orcid.org/0000-0002-2677-1028 (2018) Cost-utility Analysis of Routine Anxiety and Depression Screening in Patients Consulting for Osteoarthritis: results from the POST Trial. Arthritis Care and Research, 70 (12). pp. 1787-1794.

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Abstract

OBJECTIVE: To investigate the cost-effectiveness (cost-utility) of introducing general practitioner screening for anxiety and depression in patients consulting with osteoarthritis (OA). METHODS: A cluster-randomised trial-based economic evaluation to assess general practitioners screening for anxiety and depression symptoms in patients consulting with OA compared to usual care (screening for pain intensity) was undertaken over a 12-month period from a UK National Health Service and Societal perspective. Patient-level mean costs and mean quality-adjusted life years (QALYs) were estimated and cost-effectiveness acceptability curves controlling for cluster-level data were constructed. The base-case analysis used the net-benefit regressions approach. The two-stage non-parametric sampling technique was explored in a sensitivity analysis. RESULTS: The base-case analysis demonstrated that the intervention was as costly as, and less effective than, the control (QALY diff, 95% CI: - 0.029 (95% CI -0.062 to 0.003)). In the base-case analyses, GP screening for anxiety and depression was unlikely to be a cost-effective option (probability < 5% at £20,000/QALY). Similar results were observed in all sensitivity analyses. CONCLUSIONS: Prompting GP's to routinely screen and manage comorbid anxiety and depression in patients presenting with OA is unlikely to be cost-effective. Further research is needed to explore clinically-effective and cost-effective models of managing anxiety and depression in patients presenting with clinical OA. This article is protected by copyright. All rights reserved.

Item Type: Article
Additional Information: This is the final published version of the article (version of record). It first appeared online via Wiley at http://doi.org/10.1002/acr.23568 - please refer to any applicable terms of use of the publisher.
Uncontrolled Keywords: case-finding, anxiety, cost-effectiveness, cost-utility, depression, economic evaluation, osteoarthritis, screening
Subjects: R Medicine > RC Internal medicine > RC925 Diseases of the musculoskeletal system
Divisions: Faculty of Medicine and Health Sciences > Primary Care Health Sciences
Related URLs:
Depositing User: Symplectic
Date Deposited: 12 Dec 2018 15:49
Last Modified: 11 Jan 2019 14:28
URI: http://eprints.keele.ac.uk/id/eprint/5585

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