Mental health support for older adults needs to improve

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Dave Steele summarises an NIHR funded mixed methods study that concludes we don’t know much about how we should support older adults with mental health problems, except to say that we should be doing better.

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Are treatments for bipolar disorder cost-effective?

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Chris Sampson reports on a recent systematic review and critical appraisal of economic evaluations in bipolar disorder. He finds that there’s a pressing need for new studies, especially discrete event simulations.

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Cytisine and varenicline for smoking cessation

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Andrew Jones and Chris Sampson report on a systematic review and economic evaluation of cytisine and varenicline for smoking cessation, which finds that both drugs are clinically effective compared with placebo.

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Joint crisis plans: cost-effective for whom?

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Chris Sampson looks at the economic outcomes of a recent RCT of joint crisis plans to reduce compulsory treatment for people with psychosis. The study reports the potential for gains specifically among Black patients.

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The cost-effectiveness of liaison psychiatry: the case of RAID

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Liaison psychiatry brings together medical and psychiatric staff in hospital wards and emergency departments, with the aim of more adequately addressing comorbidities between physical and mental health. It’s something that’s been discussed in the Woodland before, with recommendations for wider implementation. The Guardian recently published an article discussing the findings of a recent study and [read the full story...]

Is telephone peer support for the prevention of postnatal depression worth the cost?

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. Peer support has been a hot topic in the woodland recently. Although there appears to be a lack of evidence to support the clinical effectiveness of peer support interventions for people with severe mental illness, such as bipolar disorder and schizophrenia, it is an approach that is highly valued by many. It might be [read the full story...]

CBT is more cost-effective than SSRI alone as treatment for panic disorder

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In addition to its impact on quality of life, panic disorder can have a number of costly consequences such as lost productivity – particularly if also associated with agoraphobia. Cost-effectiveness is therefore an important consideration in choosing the optimal treatment for panic disorder, which might improve value via the cost side of the equation. A recent [read the full story...]

Is treatment for depression cost-effective in people with diabetes?

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There is evidence to suggest that people with diabetes are twice as likely to suffer from depression. It’s therefore important that the cost-effectiveness of treatments for comorbid depression be indentified. The elves have already reported on a review of the effectiveness of collaborative care for people with diabetes and depression, suggesting that the intervention might be effective. While [read the full story...]

Cost-effectiveness of St John’s wort for treatment of depression

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Herbal medicines often represent a cheaper alternative, or a low-cost complement, to standard pharmacotherapy. As a result, improved cost-effectiveness is often touted as a likely benefit of the use of complementary and alternative medicine (CAM). Many, myself included, have been openly critical of CAM research, while others have suggested ways in which CAM research could [read the full story...]

Adherence therapy no more cost-effective than health education for people with schizophrenia

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When two interventions are demonstrably equivalent in terms of clinical outcomes, it is unclear which should be provided. One obvious decision rule in this case is to implement the intervention that is least costly and therefore most cost-effective. A recent economic evaluation by Patel and colleagues estimates the cost-effectiveness of adherence therapy for people with [read the full story...]