2026-06-03T03:09:30Zhttps://riuma.uma.es/rest/oai/request

oai:riuma.uma.es:10630/336142026-02-03T11:24:57Zcom_10630_2254col_10630_37953

00925njm 22002777a 4500 dc Varela-Moreno, Esperanza author Anarte-Ortiz, María Teresa author Jódar-Sánchez, Francisco author Garcia-Palacios, Azucena author Monreal-Bartolomé, Alicia author Gili, Margalida author Garcia Campayo, Javier author Mayoral Cleries, Fermín author 2024-05-16 Objective: This study aimed to analyze the cost-effectiveness and cost-utility of a web-based psychological intervention to treat depressive symptomatology in people with T2DM compared with TAU in a PC setting. Methods: A multicenter randomized controlled trial was conducted with 49 patients with T2DM, depressive symptoms of moderate severity, and glycosylated hemoglobin (HbA1c) of 7.47% in PC settings. Patients were randomized to TAU (n=27) or a web-based psychological treatment group (n=22). This web-based treatment consisted of cognitive behavioral therapy, improvement of diabetes self-care behaviors, and mindfulness. Cost-effectiveness analysis for the improvement of depressive symptomatology was conducted based on reductions in 3, 5, or 50 points on the Patient Health Questionnaire-9 (PHQ-9). The efficacy of diabetes control was estimated based on a 0.5% reduction in HbA1c levels. Follow-up was performed at 3 and 6 months. The cost-utility analysis was performed based on quality-adjusted life years. Results: Efficacy analysis showed that the web-based treatment program was more effective in improving depressive symptoms than TAU but showed only a slight improvement in HbA1c. Incremental cost-effectiveness ratios of 186.76 for a 3-point reduction in PHQ-9 and 206.31 for reductions of 5 and 50 percentage points were obtained. In contrast, the incremental cost-effectiveness ratio for improving HbA1c levels amounted to €1510.90 (€1=US $1.18 in 2018) per participant. The incremental cost-utility ratio resulted in €4119.33 per quality-adjusted life year gained. Conclusions: The intervention, using web-based modules incorporating cognitive behavioral therapy tools, diabetes self-care promotion, and mindfulness, effectively reduced depressive symptoms and enhanced glycemic control in patients with T2DM. Notably, it demonstrated clinical efficacy and economic efficiency. Varela-Moreno, E., Anarte-Ortiz, M. T., Jodar-Sanchez, F., Garcia-Palacios, A., Monreal-Bartolomé, A., Gili, M., García-Campayo, J., & Mayoral-Cleries, F. (2024). Economic Evaluation of a Web Application Implemented in Primary Care for the Treatment of Depression in Patients With Type 2 Diabetes Mellitus: Multicenter Randomized Controlled Trial. JMIR mHealth and uHealth, 12, e55483. https://doi.org/10.2196/55483 https://hdl.handle.net/10630/33614 10.2196/55483 Depresión Economic Evaluation of a Web Application Implemented in Primary Care for the Treatment of Depression in Patients With Type 2 Diabetes Mellitus: Multicenter Randomized Controlled Trial