2026-05-30T07:32:33Zhttps://riuma.uma.es/rest/oai/request

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

Varela-Moreno, Esperanza Anarte-Ortiz, María Teresa Jódar-Sánchez, Francisco Garcia-Palacios, Azucena Monreal-Bartolomé, Alicia Gili, Margalida Garcia Campayo, Javier Mayoral Cleries, Fermín 2024-09-27T09:05:56Z 2024-09-27T09:05:56Z 2024-05-16 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 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. eng open access 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 journal article