DIAMOS is a cognitive behavioral therapy for people with diabetes and subclinical depression to stimulate their self-management. In a randomized controlled trial, DIAMOS was shown to be effective as fewer depressive symptoms and diabetes-related distress were observed compared to the control group. The probability of clinical depression was reduced by 37% in the intervention group compared to the control group.
A health economic evaluation carried out as a cost-effectiveness or cost-utility analysis of the DIAMOS cognitive-behavioral intervention program.
Patients with diabetes and subclinical depression were randomly assigned either to a two-week diabetes-specific cognitive-behavioral group therapy comprising 5 group sessions of 90 minutes each (n=104) or a standardized diabetes education program (n=104). The patients were monitored for 12 months. During this period, data on total health care costs, patient costs and societal productivity costs were collected in addition to clinical data. Health-related quality of life (the SF-36 and EQ-5D) was measured before the start of the intervention, immediately after the intervention and 6 and 12 months after the intervention. Quality-adjusted life years (QALYs) and cumulative costs are calculated for both strands of the study. Finally, the incremental cost-utility ratio (ICUR) is calculated as cost per QALY obtained. The cost-effectiveness of diabetes-specific cognitive-behavioral therapy is analyzed from the perspective of the German statutory health insurance and from the societal perspective.
Chernyak N, Kulzer B, Hermanns N, Schmitt A, Gahr A, Haak T, Kruse J, Ohmann C, Scheer M, Giani G, Icks A. Study protocol: Within-trial economic evaluation of diabetes-specific cognitive behaviour therapy in patients with type 2 diabetes and subthreshold depression. BMC Public Health 2010 Oct 19; 10: 625