Background: Low- and middle-income countries lack information on contextualised mental health interventions to aid resource allocation decisions regarding healthcare.
Aims: To undertake a cost-effectiveness analysis of treatments for depression contextualised to Chile.
Methods: Using data from studies in Chile, we developed a computer-based Markov cohort model of depression among Chilean women to evaluate the cost-effectiveness of usual care or improved stepped care.
Results: The incremental cost-effectiveness ratio (ICER) of usual care was I$113 per quality-adjusted life-year (QALY) gained, versus no treatment, whereas stepped care had an ICER of I$468 per QALY versus usual care. This compared favourably with Chile's per-capita GDP. Results were most sensitive to variation in recurrent episode coverage, marginally sensitive to cost of treatment, and insensitive to changes in health-state utility of depression and rate of recurrence.
Conclusions: Our results suggest that treatments for depression in low- and middle-income countries may be more cost-effective than previously estimated.
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http://dx.doi.org/10.1192/bjp.bp.109.068957 | DOI Listing |
QJM
January 2025
HRB Clinical Research Facility Galway, School of Medicine, University of Galway, Galway, Ireland.
Background: The optimal approach to the diagnosis of atrial fibrillation in primary care is unclear.
Aim: To determine if external loop recorder (ELR) screening improves atrial fibrillation detection in community dwelling adults with a CHA2DS2-VASc score of greater than two.
Design: Randomised cross-over clinical trial.
J Med Internet Res
January 2025
School of Health Sciences, Center for Health Technology and Services Research, University of Aveiro, Aveiro, Portugal.
Background: Digital solutions, such as mobile apps or telemonitoring devices, are frequently considered facilitators in the process of empowering older adults, but they can also act as a source of digital exclusion or disempowerment if they are not adequate for older adults' needs and characteristics.
Objective: This study aimed to synthesize and critically evaluate existing evidence on the effectiveness of integrated digital solutions that enable interaction for empowering older adults in aspects related to their health and to explore potential factors (eg, type of technology, participants' characteristics) impacting effectiveness.
Methods: A systematic search was carried out in PubMed, ScienceDirect, SCOPUS, EBSCO, and SciELO using a combination of terms informed by previous reviews on empowerment.
Objective: Young adults experiencing homelessness are at high risk for alcohol-related consequences, but protective behavioral strategies (PBS) have not been investigated as a harm reduction approach in this population. This study examines longitudinal associations between PBS and alcohol-related consequences following a group-based alcohol intervention.
Method: Data come from AWARE, a randomized controlled trial of a group-based motivational intervention to reduce substance use and risky sex compared to usual care.
JAMA Netw Open
January 2025
HealthPartners Institute, Bloomington, Minnesota.
Importance: Medication adherence is important for managing blood pressure (BP), low-density lipoprotein cholesterol (LDL-C), and hemoglobin A1c (HbA1c). Interventions to improve medication adherence are needed.
Objective: To examine the effectiveness of an intervention using algorithmic identification of low medication adherence, clinical decision support to physicians, and pharmacist outreach to patients to improve cardiometabolic medication adherence and BP, LDL-C, and HbA1c control.
JAMA Oncol
January 2025
Division of Hematologic Malignancies, Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.
Importance: Although sharing care with local oncologists after allogeneic hematopoietic cell transplantation (HCT) has been proposed for patients living far from HCT centers, it is not known whether a shared strategy is safe or improves patient quality of life (QOL).
Objective: To determine the efficacy and safety of sharing follow-up care after HCT between the HCT specialty center and local oncologists.
Design, Setting, And Participants: This was a multicenter collaborative randomized clinical trial of patients undergoing HCT at Dana-Farber Cancer Institute (DFCI)-a high volume HCT center in Boston (Massachusetts)-and 8 local oncology practices.
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