Jesse Kigozi
Cost-Utility Analysis of Routine Anxiety and Depression Screening in Patients Consulting for Osteoarthritis: Results From a Clinical, Randomized Controlled Trial
Kigozi, Jesse; Jowett, Sue; Nicholl, Barbara I.; Lewis, Martyn; Bartlam, Bernadette; Green, Daniel; Belcher, John; Clarkson, Kris; Lingard, Zoe; Pope, Christopher; Chew-Graham, Carolyn A.; Croft, Peter; Hay, Elaine; Peat, George; Mallen, Christian D.
Authors
Sue Jowett
Barbara I. Nicholl
Alyn Lewis a.m.lewis@keele.ac.uk
Bernadette Bartlam
Daniel Green
John Belcher j.belcher@keele.ac.uk
Kris Clarkson
Zoe Lingard
Christopher Pope
Carolyn Chew-Graham c.a.chew-graham@keele.ac.uk
Peter Croft
Elaine Hay e.m.hay@keele.ac.uk
George Peat
Christian Mallen c.d.mallen@keele.ac.uk
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.
Journal Article Type | Article |
---|---|
Acceptance Date | Mar 27, 2018 |
Online Publication Date | Apr 2, 2018 |
Publication Date | Dec 1, 2018 |
Publicly Available Date | May 26, 2023 |
Journal | Arthritis Care and Research |
Print ISSN | 2151-464X |
Publisher | Wiley |
Peer Reviewed | Peer Reviewed |
Volume | 70 |
Issue | 12 |
Pages | 1787-1794 |
DOI | https://doi.org/10.1002/acr.23568 |
Keywords | case-finding, anxiety, cost-effectiveness, cost-utility, depression, economic evaluation, osteoarthritis, screening |
Publisher URL | http://doi.org/10.1002/acr.23568 |
Files
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Publisher Licence URL
https://creativecommons.org/licenses/by-nc/4.0/
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