Cost Effectiveness of a Pharmacy-Based Coaching Programme to Improve Adherence to Antidepressants

Introduction The efficacy of antidepressants in the treatment of depression has been convincingly demonstrated in randomised trials. However, non-adherence to antidepressant treatment is common. Objective To evaluate, from a societal perspective, the cost effectiveness of a pharmacy-based intervention to improve adherence to antidepressant therapy in adult patients receiving treatment in primary care. Methods An economic evaluation was performed alongside a 6-month randomised controlled trial in The Netherlands. Patients who came to 19 pharmacies with a new prescription for a non-tricyclic antidepressant, i.e. those who had not received any prescription for an antidepressant in the past 6 months, were invited to participate. They were then randomly allocated to education and coaching by the pharmacist or to usual care. The coaching programme consisted of three contacts with the pharmacist, with a mean duration of between 13 and 20 minutes, and a take-home video reviewing important facts on depression and antidepressant treatment. The clinical outcome measures were adherence to antidepressant treatment measured using an electronic pill container (eDEM) and improvement in depressive symptoms measured using the Hopkins Symptom Checklist (SCL). Resource use was measured by means of questionnaires. The uncertainty around differences in costs and cost effectiveness between the treatment groups was evaluated using bootstrapping. Results Seventy patients were randomised to the intervention group and 81 to the usual care group; of these, 40 in the intervention group and 48 in the control group completed all of the follow-up questionnaires. There were no significant differences in adherence, improvements in the SCL depression mean item score and costs over 6 months between the two treatment groups. Mean total costs (2002 values) were €3275 in the intervention group and €2961 in the control group (mean difference €315; 95% CI —1922, 2416). The incremental cost-effectiveness ratio associated with the pharmacist intervention was €149 per 1% improvement in adherence and €2550 per point improvement in the SCL depression mean item score. Cost-effectiveness planes and acceptability curves indicated that the pharmacist intervention was not likely to be cost effective compared with usual care. Conclusion In patients starting treatment with antidepressants, there were no significant differences in adherence, severity of depression, costs and cost effectiveness between patients receiving coaching by a pharmacist and patients receiving usual care after 6 months. Considering the resources needed to implement an intervention like this in clinical practice, based on these results, the continuation of usual care is recommended. Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Bosmans, Judith E. [verfasserIn] Brook, Oscar H. [verfasserIn] van Hout, Hein P. J. [verfasserIn] de Bruijne, Martine C. [verfasserIn] Nieuwenhuyse, Hugo [verfasserIn] Bouter, Lex M. [verfasserIn] Stalman, Wim A. B. [verfasserIn] van Tulder, Maurits W. [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2007

Schlagwörter:	Usual Care Antidepressant Treatment Community Pharmacist Usual Care Group Human Capital Approach

Übergeordnetes Werk:	Enthalten in: PharmacoEconomics - Berlin [u.a.] : Springer, 1992, 25(2007), 1 vom: Jan., Seite 25-37
Übergeordnetes Werk:	volume:25 ; year:2007 ; number:1 ; month:01 ; pages:25-37

Links:	Volltext

DOI / URN:	10.2165/00019053-200725010-00004

Katalog-ID:	SPR033338302

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520			\|a Introduction The efficacy of antidepressants in the treatment of depression has been convincingly demonstrated in randomised trials. However, non-adherence to antidepressant treatment is common. Objective To evaluate, from a societal perspective, the cost effectiveness of a pharmacy-based intervention to improve adherence to antidepressant therapy in adult patients receiving treatment in primary care. Methods An economic evaluation was performed alongside a 6-month randomised controlled trial in The Netherlands. Patients who came to 19 pharmacies with a new prescription for a non-tricyclic antidepressant, i.e. those who had not received any prescription for an antidepressant in the past 6 months, were invited to participate. They were then randomly allocated to education and coaching by the pharmacist or to usual care. The coaching programme consisted of three contacts with the pharmacist, with a mean duration of between 13 and 20 minutes, and a take-home video reviewing important facts on depression and antidepressant treatment. The clinical outcome measures were adherence to antidepressant treatment measured using an electronic pill container (eDEM) and improvement in depressive symptoms measured using the Hopkins Symptom Checklist (SCL). Resource use was measured by means of questionnaires. The uncertainty around differences in costs and cost effectiveness between the treatment groups was evaluated using bootstrapping. Results Seventy patients were randomised to the intervention group and 81 to the usual care group; of these, 40 in the intervention group and 48 in the control group completed all of the follow-up questionnaires. There were no significant differences in adherence, improvements in the SCL depression mean item score and costs over 6 months between the two treatment groups. Mean total costs (2002 values) were €3275 in the intervention group and €2961 in the control group (mean difference €315; 95% CI —1922, 2416). The incremental cost-effectiveness ratio associated with the pharmacist intervention was €149 per 1% improvement in adherence and €2550 per point improvement in the SCL depression mean item score. Cost-effectiveness planes and acceptability curves indicated that the pharmacist intervention was not likely to be cost effective compared with usual care. Conclusion In patients starting treatment with antidepressants, there were no significant differences in adherence, severity of depression, costs and cost effectiveness between patients receiving coaching by a pharmacist and patients receiving usual care after 6 months. Considering the resources needed to implement an intervention like this in clinical practice, based on these results, the continuation of usual care is recommended.
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allfields	10.2165/00019053-200725010-00004 doi (DE-627)SPR033338302 (SPR)00019053-200725010-00004-e DE-627 ger DE-627 rakwb eng 610 ASE 44.40 bkl Bosmans, Judith E. verfasserin aut Cost Effectiveness of a Pharmacy-Based Coaching Programme to Improve Adherence to Antidepressants 2007 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction The efficacy of antidepressants in the treatment of depression has been convincingly demonstrated in randomised trials. However, non-adherence to antidepressant treatment is common. Objective To evaluate, from a societal perspective, the cost effectiveness of a pharmacy-based intervention to improve adherence to antidepressant therapy in adult patients receiving treatment in primary care. Methods An economic evaluation was performed alongside a 6-month randomised controlled trial in The Netherlands. Patients who came to 19 pharmacies with a new prescription for a non-tricyclic antidepressant, i.e. those who had not received any prescription for an antidepressant in the past 6 months, were invited to participate. They were then randomly allocated to education and coaching by the pharmacist or to usual care. The coaching programme consisted of three contacts with the pharmacist, with a mean duration of between 13 and 20 minutes, and a take-home video reviewing important facts on depression and antidepressant treatment. The clinical outcome measures were adherence to antidepressant treatment measured using an electronic pill container (eDEM) and improvement in depressive symptoms measured using the Hopkins Symptom Checklist (SCL). Resource use was measured by means of questionnaires. The uncertainty around differences in costs and cost effectiveness between the treatment groups was evaluated using bootstrapping. Results Seventy patients were randomised to the intervention group and 81 to the usual care group; of these, 40 in the intervention group and 48 in the control group completed all of the follow-up questionnaires. There were no significant differences in adherence, improvements in the SCL depression mean item score and costs over 6 months between the two treatment groups. Mean total costs (2002 values) were €3275 in the intervention group and €2961 in the control group (mean difference €315; 95% CI —1922, 2416). The incremental cost-effectiveness ratio associated with the pharmacist intervention was €149 per 1% improvement in adherence and €2550 per point improvement in the SCL depression mean item score. Cost-effectiveness planes and acceptability curves indicated that the pharmacist intervention was not likely to be cost effective compared with usual care. Conclusion In patients starting treatment with antidepressants, there were no significant differences in adherence, severity of depression, costs and cost effectiveness between patients receiving coaching by a pharmacist and patients receiving usual care after 6 months. Considering the resources needed to implement an intervention like this in clinical practice, based on these results, the continuation of usual care is recommended. Usual Care (dpeaa)DE-He213 Antidepressant Treatment (dpeaa)DE-He213 Community Pharmacist (dpeaa)DE-He213 Usual Care Group (dpeaa)DE-He213 Human Capital Approach (dpeaa)DE-He213 Brook, Oscar H. verfasserin aut van Hout, Hein P. J. verfasserin aut de Bruijne, Martine C. verfasserin aut Nieuwenhuyse, Hugo verfasserin aut Bouter, Lex M. verfasserin aut Stalman, Wim A. B. verfasserin aut van Tulder, Maurits W. verfasserin aut Enthalten in PharmacoEconomics Berlin [u.a.] : Springer, 1992 25(2007), 1 vom: Jan., Seite 25-37 (DE-627)327645717 (DE-600)2043876-X 1179-2027 nnns volume:25 year:2007 number:1 month:01 pages:25-37 https://dx.doi.org/10.2165/00019053-200725010-00004 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA SSG-OPC-PHA SSG-OPC-ASE GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_266 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.40 ASE AR 25 2007 1 01 25-37
spelling	10.2165/00019053-200725010-00004 doi (DE-627)SPR033338302 (SPR)00019053-200725010-00004-e DE-627 ger DE-627 rakwb eng 610 ASE 44.40 bkl Bosmans, Judith E. verfasserin aut Cost Effectiveness of a Pharmacy-Based Coaching Programme to Improve Adherence to Antidepressants 2007 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction The efficacy of antidepressants in the treatment of depression has been convincingly demonstrated in randomised trials. However, non-adherence to antidepressant treatment is common. Objective To evaluate, from a societal perspective, the cost effectiveness of a pharmacy-based intervention to improve adherence to antidepressant therapy in adult patients receiving treatment in primary care. Methods An economic evaluation was performed alongside a 6-month randomised controlled trial in The Netherlands. Patients who came to 19 pharmacies with a new prescription for a non-tricyclic antidepressant, i.e. those who had not received any prescription for an antidepressant in the past 6 months, were invited to participate. They were then randomly allocated to education and coaching by the pharmacist or to usual care. The coaching programme consisted of three contacts with the pharmacist, with a mean duration of between 13 and 20 minutes, and a take-home video reviewing important facts on depression and antidepressant treatment. The clinical outcome measures were adherence to antidepressant treatment measured using an electronic pill container (eDEM) and improvement in depressive symptoms measured using the Hopkins Symptom Checklist (SCL). Resource use was measured by means of questionnaires. The uncertainty around differences in costs and cost effectiveness between the treatment groups was evaluated using bootstrapping. Results Seventy patients were randomised to the intervention group and 81 to the usual care group; of these, 40 in the intervention group and 48 in the control group completed all of the follow-up questionnaires. There were no significant differences in adherence, improvements in the SCL depression mean item score and costs over 6 months between the two treatment groups. Mean total costs (2002 values) were €3275 in the intervention group and €2961 in the control group (mean difference €315; 95% CI —1922, 2416). The incremental cost-effectiveness ratio associated with the pharmacist intervention was €149 per 1% improvement in adherence and €2550 per point improvement in the SCL depression mean item score. Cost-effectiveness planes and acceptability curves indicated that the pharmacist intervention was not likely to be cost effective compared with usual care. Conclusion In patients starting treatment with antidepressants, there were no significant differences in adherence, severity of depression, costs and cost effectiveness between patients receiving coaching by a pharmacist and patients receiving usual care after 6 months. Considering the resources needed to implement an intervention like this in clinical practice, based on these results, the continuation of usual care is recommended. Usual Care (dpeaa)DE-He213 Antidepressant Treatment (dpeaa)DE-He213 Community Pharmacist (dpeaa)DE-He213 Usual Care Group (dpeaa)DE-He213 Human Capital Approach (dpeaa)DE-He213 Brook, Oscar H. verfasserin aut van Hout, Hein P. J. verfasserin aut de Bruijne, Martine C. verfasserin aut Nieuwenhuyse, Hugo verfasserin aut Bouter, Lex M. verfasserin aut Stalman, Wim A. B. verfasserin aut van Tulder, Maurits W. verfasserin aut Enthalten in PharmacoEconomics Berlin [u.a.] : Springer, 1992 25(2007), 1 vom: Jan., Seite 25-37 (DE-627)327645717 (DE-600)2043876-X 1179-2027 nnns volume:25 year:2007 number:1 month:01 pages:25-37 https://dx.doi.org/10.2165/00019053-200725010-00004 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA SSG-OPC-PHA SSG-OPC-ASE GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_266 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.40 ASE AR 25 2007 1 01 25-37
allfields_unstemmed	10.2165/00019053-200725010-00004 doi (DE-627)SPR033338302 (SPR)00019053-200725010-00004-e DE-627 ger DE-627 rakwb eng 610 ASE 44.40 bkl Bosmans, Judith E. verfasserin aut Cost Effectiveness of a Pharmacy-Based Coaching Programme to Improve Adherence to Antidepressants 2007 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction The efficacy of antidepressants in the treatment of depression has been convincingly demonstrated in randomised trials. However, non-adherence to antidepressant treatment is common. Objective To evaluate, from a societal perspective, the cost effectiveness of a pharmacy-based intervention to improve adherence to antidepressant therapy in adult patients receiving treatment in primary care. Methods An economic evaluation was performed alongside a 6-month randomised controlled trial in The Netherlands. Patients who came to 19 pharmacies with a new prescription for a non-tricyclic antidepressant, i.e. those who had not received any prescription for an antidepressant in the past 6 months, were invited to participate. They were then randomly allocated to education and coaching by the pharmacist or to usual care. The coaching programme consisted of three contacts with the pharmacist, with a mean duration of between 13 and 20 minutes, and a take-home video reviewing important facts on depression and antidepressant treatment. The clinical outcome measures were adherence to antidepressant treatment measured using an electronic pill container (eDEM) and improvement in depressive symptoms measured using the Hopkins Symptom Checklist (SCL). Resource use was measured by means of questionnaires. The uncertainty around differences in costs and cost effectiveness between the treatment groups was evaluated using bootstrapping. Results Seventy patients were randomised to the intervention group and 81 to the usual care group; of these, 40 in the intervention group and 48 in the control group completed all of the follow-up questionnaires. There were no significant differences in adherence, improvements in the SCL depression mean item score and costs over 6 months between the two treatment groups. Mean total costs (2002 values) were €3275 in the intervention group and €2961 in the control group (mean difference €315; 95% CI —1922, 2416). The incremental cost-effectiveness ratio associated with the pharmacist intervention was €149 per 1% improvement in adherence and €2550 per point improvement in the SCL depression mean item score. Cost-effectiveness planes and acceptability curves indicated that the pharmacist intervention was not likely to be cost effective compared with usual care. Conclusion In patients starting treatment with antidepressants, there were no significant differences in adherence, severity of depression, costs and cost effectiveness between patients receiving coaching by a pharmacist and patients receiving usual care after 6 months. Considering the resources needed to implement an intervention like this in clinical practice, based on these results, the continuation of usual care is recommended. Usual Care (dpeaa)DE-He213 Antidepressant Treatment (dpeaa)DE-He213 Community Pharmacist (dpeaa)DE-He213 Usual Care Group (dpeaa)DE-He213 Human Capital Approach (dpeaa)DE-He213 Brook, Oscar H. verfasserin aut van Hout, Hein P. J. verfasserin aut de Bruijne, Martine C. verfasserin aut Nieuwenhuyse, Hugo verfasserin aut Bouter, Lex M. verfasserin aut Stalman, Wim A. B. verfasserin aut van Tulder, Maurits W. verfasserin aut Enthalten in PharmacoEconomics Berlin [u.a.] : Springer, 1992 25(2007), 1 vom: Jan., Seite 25-37 (DE-627)327645717 (DE-600)2043876-X 1179-2027 nnns volume:25 year:2007 number:1 month:01 pages:25-37 https://dx.doi.org/10.2165/00019053-200725010-00004 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA SSG-OPC-PHA SSG-OPC-ASE GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_266 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.40 ASE AR 25 2007 1 01 25-37
allfieldsGer	10.2165/00019053-200725010-00004 doi (DE-627)SPR033338302 (SPR)00019053-200725010-00004-e DE-627 ger DE-627 rakwb eng 610 ASE 44.40 bkl Bosmans, Judith E. verfasserin aut Cost Effectiveness of a Pharmacy-Based Coaching Programme to Improve Adherence to Antidepressants 2007 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction The efficacy of antidepressants in the treatment of depression has been convincingly demonstrated in randomised trials. However, non-adherence to antidepressant treatment is common. Objective To evaluate, from a societal perspective, the cost effectiveness of a pharmacy-based intervention to improve adherence to antidepressant therapy in adult patients receiving treatment in primary care. Methods An economic evaluation was performed alongside a 6-month randomised controlled trial in The Netherlands. Patients who came to 19 pharmacies with a new prescription for a non-tricyclic antidepressant, i.e. those who had not received any prescription for an antidepressant in the past 6 months, were invited to participate. They were then randomly allocated to education and coaching by the pharmacist or to usual care. The coaching programme consisted of three contacts with the pharmacist, with a mean duration of between 13 and 20 minutes, and a take-home video reviewing important facts on depression and antidepressant treatment. The clinical outcome measures were adherence to antidepressant treatment measured using an electronic pill container (eDEM) and improvement in depressive symptoms measured using the Hopkins Symptom Checklist (SCL). Resource use was measured by means of questionnaires. The uncertainty around differences in costs and cost effectiveness between the treatment groups was evaluated using bootstrapping. Results Seventy patients were randomised to the intervention group and 81 to the usual care group; of these, 40 in the intervention group and 48 in the control group completed all of the follow-up questionnaires. There were no significant differences in adherence, improvements in the SCL depression mean item score and costs over 6 months between the two treatment groups. Mean total costs (2002 values) were €3275 in the intervention group and €2961 in the control group (mean difference €315; 95% CI —1922, 2416). The incremental cost-effectiveness ratio associated with the pharmacist intervention was €149 per 1% improvement in adherence and €2550 per point improvement in the SCL depression mean item score. Cost-effectiveness planes and acceptability curves indicated that the pharmacist intervention was not likely to be cost effective compared with usual care. Conclusion In patients starting treatment with antidepressants, there were no significant differences in adherence, severity of depression, costs and cost effectiveness between patients receiving coaching by a pharmacist and patients receiving usual care after 6 months. Considering the resources needed to implement an intervention like this in clinical practice, based on these results, the continuation of usual care is recommended. Usual Care (dpeaa)DE-He213 Antidepressant Treatment (dpeaa)DE-He213 Community Pharmacist (dpeaa)DE-He213 Usual Care Group (dpeaa)DE-He213 Human Capital Approach (dpeaa)DE-He213 Brook, Oscar H. verfasserin aut van Hout, Hein P. J. verfasserin aut de Bruijne, Martine C. verfasserin aut Nieuwenhuyse, Hugo verfasserin aut Bouter, Lex M. verfasserin aut Stalman, Wim A. B. verfasserin aut van Tulder, Maurits W. verfasserin aut Enthalten in PharmacoEconomics Berlin [u.a.] : Springer, 1992 25(2007), 1 vom: Jan., Seite 25-37 (DE-627)327645717 (DE-600)2043876-X 1179-2027 nnns volume:25 year:2007 number:1 month:01 pages:25-37 https://dx.doi.org/10.2165/00019053-200725010-00004 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA SSG-OPC-PHA SSG-OPC-ASE GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_266 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.40 ASE AR 25 2007 1 01 25-37
allfieldsSound	10.2165/00019053-200725010-00004 doi (DE-627)SPR033338302 (SPR)00019053-200725010-00004-e DE-627 ger DE-627 rakwb eng 610 ASE 44.40 bkl Bosmans, Judith E. verfasserin aut Cost Effectiveness of a Pharmacy-Based Coaching Programme to Improve Adherence to Antidepressants 2007 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction The efficacy of antidepressants in the treatment of depression has been convincingly demonstrated in randomised trials. However, non-adherence to antidepressant treatment is common. Objective To evaluate, from a societal perspective, the cost effectiveness of a pharmacy-based intervention to improve adherence to antidepressant therapy in adult patients receiving treatment in primary care. Methods An economic evaluation was performed alongside a 6-month randomised controlled trial in The Netherlands. Patients who came to 19 pharmacies with a new prescription for a non-tricyclic antidepressant, i.e. those who had not received any prescription for an antidepressant in the past 6 months, were invited to participate. They were then randomly allocated to education and coaching by the pharmacist or to usual care. The coaching programme consisted of three contacts with the pharmacist, with a mean duration of between 13 and 20 minutes, and a take-home video reviewing important facts on depression and antidepressant treatment. The clinical outcome measures were adherence to antidepressant treatment measured using an electronic pill container (eDEM) and improvement in depressive symptoms measured using the Hopkins Symptom Checklist (SCL). Resource use was measured by means of questionnaires. The uncertainty around differences in costs and cost effectiveness between the treatment groups was evaluated using bootstrapping. Results Seventy patients were randomised to the intervention group and 81 to the usual care group; of these, 40 in the intervention group and 48 in the control group completed all of the follow-up questionnaires. There were no significant differences in adherence, improvements in the SCL depression mean item score and costs over 6 months between the two treatment groups. Mean total costs (2002 values) were €3275 in the intervention group and €2961 in the control group (mean difference €315; 95% CI —1922, 2416). The incremental cost-effectiveness ratio associated with the pharmacist intervention was €149 per 1% improvement in adherence and €2550 per point improvement in the SCL depression mean item score. Cost-effectiveness planes and acceptability curves indicated that the pharmacist intervention was not likely to be cost effective compared with usual care. Conclusion In patients starting treatment with antidepressants, there were no significant differences in adherence, severity of depression, costs and cost effectiveness between patients receiving coaching by a pharmacist and patients receiving usual care after 6 months. Considering the resources needed to implement an intervention like this in clinical practice, based on these results, the continuation of usual care is recommended. Usual Care (dpeaa)DE-He213 Antidepressant Treatment (dpeaa)DE-He213 Community Pharmacist (dpeaa)DE-He213 Usual Care Group (dpeaa)DE-He213 Human Capital Approach (dpeaa)DE-He213 Brook, Oscar H. verfasserin aut van Hout, Hein P. J. verfasserin aut de Bruijne, Martine C. verfasserin aut Nieuwenhuyse, Hugo verfasserin aut Bouter, Lex M. verfasserin aut Stalman, Wim A. B. verfasserin aut van Tulder, Maurits W. verfasserin aut Enthalten in PharmacoEconomics Berlin [u.a.] : Springer, 1992 25(2007), 1 vom: Jan., Seite 25-37 (DE-627)327645717 (DE-600)2043876-X 1179-2027 nnns volume:25 year:2007 number:1 month:01 pages:25-37 https://dx.doi.org/10.2165/00019053-200725010-00004 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA SSG-OPC-PHA SSG-OPC-ASE GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_266 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.40 ASE AR 25 2007 1 01 25-37
language	English
source	Enthalten in PharmacoEconomics 25(2007), 1 vom: Jan., Seite 25-37 volume:25 year:2007 number:1 month:01 pages:25-37
sourceStr	Enthalten in PharmacoEconomics 25(2007), 1 vom: Jan., Seite 25-37 volume:25 year:2007 number:1 month:01 pages:25-37
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	Usual Care Antidepressant Treatment Community Pharmacist Usual Care Group Human Capital Approach
dewey-raw	610
isfreeaccess_bool	false
container_title	PharmacoEconomics
authorswithroles_txt_mv	Bosmans, Judith E. @@aut@@ Brook, Oscar H. @@aut@@ van Hout, Hein P. J. @@aut@@ de Bruijne, Martine C. @@aut@@ Nieuwenhuyse, Hugo @@aut@@ Bouter, Lex M. @@aut@@ Stalman, Wim A. B. @@aut@@ van Tulder, Maurits W. @@aut@@
publishDateDaySort_date	2007-01-01T00:00:00Z
hierarchy_top_id	327645717
dewey-sort	3610
id	SPR033338302
language_de	englisch
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However, non-adherence to antidepressant treatment is common. Objective To evaluate, from a societal perspective, the cost effectiveness of a pharmacy-based intervention to improve adherence to antidepressant therapy in adult patients receiving treatment in primary care. Methods An economic evaluation was performed alongside a 6-month randomised controlled trial in The Netherlands. Patients who came to 19 pharmacies with a new prescription for a non-tricyclic antidepressant, i.e. those who had not received any prescription for an antidepressant in the past 6 months, were invited to participate. They were then randomly allocated to education and coaching by the pharmacist or to usual care. The coaching programme consisted of three contacts with the pharmacist, with a mean duration of between 13 and 20 minutes, and a take-home video reviewing important facts on depression and antidepressant treatment. The clinical outcome measures were adherence to antidepressant treatment measured using an electronic pill container (eDEM) and improvement in depressive symptoms measured using the Hopkins Symptom Checklist (SCL). Resource use was measured by means of questionnaires. The uncertainty around differences in costs and cost effectiveness between the treatment groups was evaluated using bootstrapping. Results Seventy patients were randomised to the intervention group and 81 to the usual care group; of these, 40 in the intervention group and 48 in the control group completed all of the follow-up questionnaires. There were no significant differences in adherence, improvements in the SCL depression mean item score and costs over 6 months between the two treatment groups. Mean total costs (2002 values) were €3275 in the intervention group and €2961 in the control group (mean difference €315; 95% CI —1922, 2416). The incremental cost-effectiveness ratio associated with the pharmacist intervention was €149 per 1% improvement in adherence and €2550 per point improvement in the SCL depression mean item score. Cost-effectiveness planes and acceptability curves indicated that the pharmacist intervention was not likely to be cost effective compared with usual care. Conclusion In patients starting treatment with antidepressants, there were no significant differences in adherence, severity of depression, costs and cost effectiveness between patients receiving coaching by a pharmacist and patients receiving usual care after 6 months. 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author	Bosmans, Judith E.
spellingShingle	Bosmans, Judith E. ddc 610 bkl 44.40 misc Usual Care misc Antidepressant Treatment misc Community Pharmacist misc Usual Care Group misc Human Capital Approach Cost Effectiveness of a Pharmacy-Based Coaching Programme to Improve Adherence to Antidepressants
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topic_title	610 ASE 44.40 bkl Cost Effectiveness of a Pharmacy-Based Coaching Programme to Improve Adherence to Antidepressants Usual Care (dpeaa)DE-He213 Antidepressant Treatment (dpeaa)DE-He213 Community Pharmacist (dpeaa)DE-He213 Usual Care Group (dpeaa)DE-He213 Human Capital Approach (dpeaa)DE-He213
topic	ddc 610 bkl 44.40 misc Usual Care misc Antidepressant Treatment misc Community Pharmacist misc Usual Care Group misc Human Capital Approach
topic_unstemmed	ddc 610 bkl 44.40 misc Usual Care misc Antidepressant Treatment misc Community Pharmacist misc Usual Care Group misc Human Capital Approach
topic_browse	ddc 610 bkl 44.40 misc Usual Care misc Antidepressant Treatment misc Community Pharmacist misc Usual Care Group misc Human Capital Approach
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title	Cost Effectiveness of a Pharmacy-Based Coaching Programme to Improve Adherence to Antidepressants
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title_full	Cost Effectiveness of a Pharmacy-Based Coaching Programme to Improve Adherence to Antidepressants
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author_browse	Bosmans, Judith E. Brook, Oscar H. van Hout, Hein P. J. de Bruijne, Martine C. Nieuwenhuyse, Hugo Bouter, Lex M. Stalman, Wim A. B. van Tulder, Maurits W.
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title_sort	cost effectiveness of a pharmacy-based coaching programme to improve adherence to antidepressants
title_auth	Cost Effectiveness of a Pharmacy-Based Coaching Programme to Improve Adherence to Antidepressants
abstract	Introduction The efficacy of antidepressants in the treatment of depression has been convincingly demonstrated in randomised trials. However, non-adherence to antidepressant treatment is common. Objective To evaluate, from a societal perspective, the cost effectiveness of a pharmacy-based intervention to improve adherence to antidepressant therapy in adult patients receiving treatment in primary care. Methods An economic evaluation was performed alongside a 6-month randomised controlled trial in The Netherlands. Patients who came to 19 pharmacies with a new prescription for a non-tricyclic antidepressant, i.e. those who had not received any prescription for an antidepressant in the past 6 months, were invited to participate. They were then randomly allocated to education and coaching by the pharmacist or to usual care. The coaching programme consisted of three contacts with the pharmacist, with a mean duration of between 13 and 20 minutes, and a take-home video reviewing important facts on depression and antidepressant treatment. The clinical outcome measures were adherence to antidepressant treatment measured using an electronic pill container (eDEM) and improvement in depressive symptoms measured using the Hopkins Symptom Checklist (SCL). Resource use was measured by means of questionnaires. The uncertainty around differences in costs and cost effectiveness between the treatment groups was evaluated using bootstrapping. Results Seventy patients were randomised to the intervention group and 81 to the usual care group; of these, 40 in the intervention group and 48 in the control group completed all of the follow-up questionnaires. There were no significant differences in adherence, improvements in the SCL depression mean item score and costs over 6 months between the two treatment groups. Mean total costs (2002 values) were €3275 in the intervention group and €2961 in the control group (mean difference €315; 95% CI —1922, 2416). The incremental cost-effectiveness ratio associated with the pharmacist intervention was €149 per 1% improvement in adherence and €2550 per point improvement in the SCL depression mean item score. Cost-effectiveness planes and acceptability curves indicated that the pharmacist intervention was not likely to be cost effective compared with usual care. Conclusion In patients starting treatment with antidepressants, there were no significant differences in adherence, severity of depression, costs and cost effectiveness between patients receiving coaching by a pharmacist and patients receiving usual care after 6 months. Considering the resources needed to implement an intervention like this in clinical practice, based on these results, the continuation of usual care is recommended.
abstractGer	Introduction The efficacy of antidepressants in the treatment of depression has been convincingly demonstrated in randomised trials. However, non-adherence to antidepressant treatment is common. Objective To evaluate, from a societal perspective, the cost effectiveness of a pharmacy-based intervention to improve adherence to antidepressant therapy in adult patients receiving treatment in primary care. Methods An economic evaluation was performed alongside a 6-month randomised controlled trial in The Netherlands. Patients who came to 19 pharmacies with a new prescription for a non-tricyclic antidepressant, i.e. those who had not received any prescription for an antidepressant in the past 6 months, were invited to participate. They were then randomly allocated to education and coaching by the pharmacist or to usual care. The coaching programme consisted of three contacts with the pharmacist, with a mean duration of between 13 and 20 minutes, and a take-home video reviewing important facts on depression and antidepressant treatment. The clinical outcome measures were adherence to antidepressant treatment measured using an electronic pill container (eDEM) and improvement in depressive symptoms measured using the Hopkins Symptom Checklist (SCL). Resource use was measured by means of questionnaires. The uncertainty around differences in costs and cost effectiveness between the treatment groups was evaluated using bootstrapping. Results Seventy patients were randomised to the intervention group and 81 to the usual care group; of these, 40 in the intervention group and 48 in the control group completed all of the follow-up questionnaires. There were no significant differences in adherence, improvements in the SCL depression mean item score and costs over 6 months between the two treatment groups. Mean total costs (2002 values) were €3275 in the intervention group and €2961 in the control group (mean difference €315; 95% CI —1922, 2416). The incremental cost-effectiveness ratio associated with the pharmacist intervention was €149 per 1% improvement in adherence and €2550 per point improvement in the SCL depression mean item score. Cost-effectiveness planes and acceptability curves indicated that the pharmacist intervention was not likely to be cost effective compared with usual care. Conclusion In patients starting treatment with antidepressants, there were no significant differences in adherence, severity of depression, costs and cost effectiveness between patients receiving coaching by a pharmacist and patients receiving usual care after 6 months. Considering the resources needed to implement an intervention like this in clinical practice, based on these results, the continuation of usual care is recommended.
abstract_unstemmed	Introduction The efficacy of antidepressants in the treatment of depression has been convincingly demonstrated in randomised trials. However, non-adherence to antidepressant treatment is common. Objective To evaluate, from a societal perspective, the cost effectiveness of a pharmacy-based intervention to improve adherence to antidepressant therapy in adult patients receiving treatment in primary care. Methods An economic evaluation was performed alongside a 6-month randomised controlled trial in The Netherlands. Patients who came to 19 pharmacies with a new prescription for a non-tricyclic antidepressant, i.e. those who had not received any prescription for an antidepressant in the past 6 months, were invited to participate. They were then randomly allocated to education and coaching by the pharmacist or to usual care. The coaching programme consisted of three contacts with the pharmacist, with a mean duration of between 13 and 20 minutes, and a take-home video reviewing important facts on depression and antidepressant treatment. The clinical outcome measures were adherence to antidepressant treatment measured using an electronic pill container (eDEM) and improvement in depressive symptoms measured using the Hopkins Symptom Checklist (SCL). Resource use was measured by means of questionnaires. The uncertainty around differences in costs and cost effectiveness between the treatment groups was evaluated using bootstrapping. Results Seventy patients were randomised to the intervention group and 81 to the usual care group; of these, 40 in the intervention group and 48 in the control group completed all of the follow-up questionnaires. There were no significant differences in adherence, improvements in the SCL depression mean item score and costs over 6 months between the two treatment groups. Mean total costs (2002 values) were €3275 in the intervention group and €2961 in the control group (mean difference €315; 95% CI —1922, 2416). The incremental cost-effectiveness ratio associated with the pharmacist intervention was €149 per 1% improvement in adherence and €2550 per point improvement in the SCL depression mean item score. Cost-effectiveness planes and acceptability curves indicated that the pharmacist intervention was not likely to be cost effective compared with usual care. Conclusion In patients starting treatment with antidepressants, there were no significant differences in adherence, severity of depression, costs and cost effectiveness between patients receiving coaching by a pharmacist and patients receiving usual care after 6 months. Considering the resources needed to implement an intervention like this in clinical practice, based on these results, the continuation of usual care is recommended.
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container_issue	1
title_short	Cost Effectiveness of a Pharmacy-Based Coaching Programme to Improve Adherence to Antidepressants
url	https://dx.doi.org/10.2165/00019053-200725010-00004
remote_bool	true
author2	Brook, Oscar H. van Hout, Hein P. J. de Bruijne, Martine C. Nieuwenhuyse, Hugo Bouter, Lex M. Stalman, Wim A. B. van Tulder, Maurits W.
author2Str	Brook, Oscar H. van Hout, Hein P. J. de Bruijne, Martine C. Nieuwenhuyse, Hugo Bouter, Lex M. Stalman, Wim A. B. van Tulder, Maurits W.
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doi_str	10.2165/00019053-200725010-00004
up_date	2024-07-03T18:02:48.262Z
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However, non-adherence to antidepressant treatment is common. Objective To evaluate, from a societal perspective, the cost effectiveness of a pharmacy-based intervention to improve adherence to antidepressant therapy in adult patients receiving treatment in primary care. Methods An economic evaluation was performed alongside a 6-month randomised controlled trial in The Netherlands. Patients who came to 19 pharmacies with a new prescription for a non-tricyclic antidepressant, i.e. those who had not received any prescription for an antidepressant in the past 6 months, were invited to participate. They were then randomly allocated to education and coaching by the pharmacist or to usual care. The coaching programme consisted of three contacts with the pharmacist, with a mean duration of between 13 and 20 minutes, and a take-home video reviewing important facts on depression and antidepressant treatment. 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