medwireNews: Findings from a modeling study suggest that community-based exercise and cognitive behavioral therapy (CBT) interventions for depression in people with type 2 diabetes are cost-effective in the long-term.
The main results from the Program ACTIVE II trial, reported previously by medwireNews, showed that these interventions, delivered individually or together, significantly improve depression, diabetes distress, and cardiometabolic outcomes relative to usual care in people with type 2 diabetes and major depressive disorder.
In the present study, a simulation model with a base-case analysis scenario assuming diminishing effectiveness over time estimated that 10-year cardiovascular and survival outcomes were “generally best” for people taking part in the exercise intervention with or without concomitant CBT, and worse for those given CBT alone or usual care.
Mary de Groot (Indiana University School of Medicine, Indianapolis, USA) and colleagues estimated that the exercise, CBT, and combination interventions were either cost-saving or highly cost-effective compared with usual care over 10 years. The exercise plus CBT intervention was associated with the longest quality-adjusted life expectancy, at 5.355 quality-adjusted life–years (QALYs), while exercise alone was associated with the lowest total costs (US$ 75,714; € 61,852). Exercise plus CBT was cost-saving or highly cost-effective compared with either intervention alone or usual care.
“These findings demonstrate the value for health care systems to partner with community-based fitness and mental health professionals to extend the availability of depression treatment options that are complementary to medical care for patients with type 2 diabetes,” conclude the researchers in Diabetes Care.
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