Cost effectiveness and cost-utility analysis of a group-based diet intervention for treating major depression – the HELFIMED trial

Segal, Leonie; Twizeyemariya, Astérie; Zarnowiecki, Dorota; Niyonsenga, Théophile; Bogomolova, Svetlana; Wilson, Andrew; O’Dea, Kerin; Parletta, Natalie

doi:10.1080/1028415x.2018.1556896

Cited by 22 publications

(25 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Similarly, systematic reviews of economic modelling studies on comparative cost-effectiveness of conventional versus integrative treatments of many health conditions (including mental illness), suggest that integrative treatments are cost-effective, and in some cases, provide cost savings [42]. Individual lifestyle interventions have also demonstrated cost-effectiveness [98,99]. Finally, higher up-front costs of integrative treatment approaches may be potentially offset by improved work productivity and increased future Quality Adjusted Life Years (QALYs) [96].…”

Section: Integrative Medicinementioning

confidence: 99%

See 1 more Smart Citation

An integrative collaborative care model for people with mental illness and physical comorbidities

Lake

Firth

et al. 2020

Int J Ment Health Syst

View full text Add to dashboard Cite

Background Many individuals with mental health problems have comorbid physical conditions, or may present with substance/alcohol misuse or abuse issues. This results in complex treatment challenges that may not be adequately addressed by a model of care that is solely delivered by an individual clinician using a sole intervention. Mainstream pharmacotherapeutic treatment of mental health problems often have limited effectiveness in completely resolving symptoms, and may cause adverse side effects. Adjunctive treatment approaches, including nutraceuticals, lifestyle and behaviour change interventions, are widely used to assist with treatment of mental health problems. However, whilst these can be generally safer with fewer side effects, they have varying levels of evidentiary support. These circumstances warrant reframing the current treatment approach towards a more evidence-based integrative model which may better address the real-world challenges of psychiatric disorders and comorbid physical conditions. In essence, this means developing an integrative model of care which embodies an evidence-informed, personalized stepwise approach using both conventional pharmacological treatments alongside novel adjunctive treatments (where applicable) via the application of a collaborative care approach. Discussion In order to inform this position, a brief review of findings on common patterns of comorbidity in mental illness is presented, followed by identification of limitations of conventional treatments, and potential applications of integrative medicine interventions. Advantages and challenges of integrative mental health care, collaborative models of care, review of research highlights of select integrative approaches, and comment on potential cost advantages are then discussed. Summary We propose that a collaborative care model incorporating evidence-based integrative medicine interventions may more adequately address mental health problems with comorbid medical conditions. Robust research is now required of such a model, potentially within an integrative clinical practice.

show abstract

Section: Integrative Medicinementioning

confidence: 99%

“…Finally, higher up-front costs of integrative treatment approaches may be potentially offset by improved work productivity and increased future Quality Adjusted Life Years (QALYs) [96]. Further, cost-effectiveness of individual lifestyle interventions has also been demonstrated [98,99].…”

Section: Integrative Medicinementioning

confidence: 99%

An integrative collaborative care model for people with mental illness and physical comorbidities

Lake

Firth

et al. 2020

Int J Ment Health Syst

View full text Add to dashboard Cite

show abstract

“…This study also showed a cost savings of ~$2500 per participant in favour of the dietary intervention due to reduced healthcare costs and reduced productivity costs (e.g., missed fewer paid and unpaid work days) [23]. A larger, group-based study using a similar approach reported very comparable findings and was also highly costeffective [25]. In addition, these studies are now corroborated by meta-analytic evidence, including data from 16 RCTs and 45,826 participants, showing that dietary improvement is also an efficacious treatment option for sub threshold depression [6], especially when delivered by accredited nutritionists or dietitians.…”

Section: Evidence Base For the Use Of Lifestyle Programs In Mental Healthmentioning

confidence: 55%

Designing Lifestyle Interventions for Common Mental Disorders: What Can We Learn from Diabetes Prevention Programs?

et al. 2021

View full text Add to dashboard Cite

Lifestyle factors including diet, sleep, physical activity, and substance use cessation, are recognised as treatment targets for common mental disorders (CMDs). As the field of lifestyle-based mental health care evolves towards effectiveness trials and real-world translation, it is timely to consider how such innovations can be integrated into clinical practice. This paper discusses the utility and scale-up of lifestyle interventions for CMDs and draws on diabetes prevention literature to identify enablers and barriers to translation efforts. We discuss the extent to which lifestyle interventions aimed at managing CMDs and preventing diabetes share commonalities (program content, theoretical underpinnings, program structures, interventionists, frameworks promoting fidelity, quality, sustainability). Specific considerations when utilising these programs for mental health include personalising content with respect to symptoms and trajectories of depression and anxiety, medication regimen and genetic risk profile. As this field moves from efficacy to effectiveness and implementation, it is important to ensure issues in implementation science, including “voltage drop”, “program drift”, logistics, funding, and resourcing, are in line with evidence-based models that are effective in research settings. Ongoing considerations includes who is best placed to deliver this care and the need for models to support implementation including long-term financing, workforce training, supervision, stakeholder and organisational support.

show abstract

“…In the HELFIMED study, a 3-month group-based Mediterranean-style diet intervention, healthy dietary changes supplemented with fish oil were found to be beneficial for treating depressive symptoms [29]. In the same study, the intervention group participating in cooking workshops was cost-effective compared to a social support group [21].…”

Section: Background and Rationale {6a}mentioning

confidence: 96%

“…Although there is little evidence of the financial benefits brought by a dietary intervention for treating depression, there are two recently published studies on the matter. One of them indicated that dietary treatment was highly cost-effective in treating major depression compared to a social support group program [21], while the other produced the same amount of QALYs with lower costs [22].…”

Section: Background and Rationale {6a}mentioning

confidence: 99%

Nutrition-focused group intervention with a strength-based counseling approach for people with clinical depression: a study protocol for the Food for Mind randomized controlled trial

Roponen

Ruusunen

Absetz

et al. 2021

Trials

View full text Add to dashboard Cite

Background Depression is a highly prevalent mental disorder with major public health effects globally. It impairs the quality of life and reduces the ability to work and function, leading to increasing costs of sick leaves and disability pensions. Current treatment strategies focus on biological and psychological pathways while understating the role of lifestyle factors. Epidemiological studies have shown convincing evidence of an inverse relationship between diet quality and depression. However, only limited data are available on the therapeutic effects of diet quality improvement on depression. Using a randomized controlled trial design, our primary aim is to investigate the effectiveness and cost-effectiveness of a behavioral nutrition group intervention compared to a social support intervention in the treatment of depression. Methods Participants (N=144, aged 20–65 years) with a diagnosis of moderate or severe depression recruited in collaboration with outpatient care units will be randomized into two arms: Food for Mind (FM) nutrition intervention (n=72) or Bring Good Mood (BGM) social support control group (n=72). Both arms will be provided with 6 group sessions over an 8-week period. FM involves improving diet quality by applying strength-based behavioral nutrition counseling and activities facilitated by a registered dietitian. The control arm comprises a befriending protocol. During the interventions, all participants will continue their treatment for depression as usual. Longitudinal data are collected at baseline, at 8 weeks, and at 6- and 12-month follow-ups. Depressive symptoms, diet quality, eating behavior, ability to work and function, and quality of life are assessed by self-reported questionnaires. A treatment expectancy questionnaire will be administered at baseline and an acceptability questionnaire at 8 weeks. The Center for Epidemiologic Studies Depression Scale is used as the primary endpoint at 1 year. The results will be analyzed with linear mixed-effects models. Economic evaluation includes both cost-effectiveness and cost-utility analysis. Two incremental cost-effectiveness ratios will be calculated to evaluate the incremental cost per QALY and the incremental cost per improvement in CES-D. Discussion If the intervention proves to be cost-effective and acceptable, it be can be implemented in healthcare to support the treatment of depression. Trial registration ClinicalTrials.gov NCT03904771. Retrospectively registered on 5 April 2019

show abstract

Cost effectiveness and cost-utility analysis of a group-based diet intervention for treating major depression – the HELFIMED trial

Abstract: Cost effectiveness and cost-utility analysis of a group-based diet intervention for treating major depression-the HELFIMED trial,

Cited by 22 publications

References 30 publications

An integrative collaborative care model for people with mental illness and physical comorbidities

An integrative collaborative care model for people with mental illness and physical comorbidities

Designing Lifestyle Interventions for Common Mental Disorders: What Can We Learn from Diabetes Prevention Programs?

Nutrition-focused group intervention with a strength-based counseling approach for people with clinical depression: a study protocol for the Food for Mind randomized controlled trial

Contact Info

Product

Resources

About