Ricken, Roland and Wiethoff, Katja and Reinhold, Thomas and Stamm, Thomas J. and Baghai, Thomas C. and Fisher, Robert and Seemueller, Florian and Brieger, Peter and Cordes, Joachim and Laux, Gerd and Hauth, Iris and Moeller, Hans-Juergen and Heinz, Andreas and Bauer, Michael and Adli, Mazda (2018) A standardized stepwise drug treatment algorithm for depression reduces direct treatment costs in depressed inpatients - Results from the German Algorithm Project (GAP3). JOURNAL OF AFFECTIVE DISORDERS, 228. pp. 173-177. ISSN 0165-0327, 1573-2517
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Background: In a previous single center study we found that a standardized drug treatment algorithm (ALGO) was more cost effective than treatment as usual (TAU) for inpatients with major depression. This report aimed to determine whether this promising initial finding could be replicated in a multicenter study. Methods: Treatment costs were calculated for two time periods: the study period (from enrolment to exit from study) and time in hospital (from enrolment to hospital discharge) based on daily hospital charges. Cost per remitted patient during the study period was considered as primary outcome. Results: 266 patients received ALGO and 84 received TAU. For the study period, ALGO costs were significantly lower than TAU (ALGO: 7 848 +/- 6 065 (sic); TAU: 10 033 +/- 7 696 (sic); p= 0.04). For time in hospital, costs were not different (ALGO: 14 734 +/- 8 329 (sic); TAU: 14 244 +/- 8 419 (sic); p = 0.617). Remission rates did not differ for the study period (ALGO: 57.9%, TAU: 50.0%; p= 0.201). Remission rates were greater in ALGO (83.3%) than TAU (66.2%) for time in hospital (p = 0.002). Cost per remission was lower in ALGO (13 554 +/- 10 476 (sic)) than TAU (20 066 +/- 15 391 (sic)) for the study period (p< 0.001) and for time in hospital (ALGO: 17 582 +/- 9 939 (sic); TAU: 21 516 +/- 12 718 (sic); p = 0.036). Limitations: Indirect costs were not assessed. Different dropout rates in TAU and ALGO complicated interpretation. Conclusions: Treatment algorithms enhance the cost effectiveness of the care of depressed inpatients, which replicates our prior results in an independent sample.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | GUIDED TREATMENT; PRIMARY-CARE; OUTCOMES; TRIAL; MANAGEMENT; DISORDERS; DISEASE; Cost effectiveness analysis; Health economy; Depression; Treatment algorithm |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Psychiatrie und Psychotherapie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 16 Mar 2020 13:38 |
| Last Modified: | 16 Mar 2020 13:38 |
| URI: | https://pred.uni-regensburg.de/id/eprint/15008 |
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