Treating elderly people with depression in their own homes could be
cheaper and more effective than conventional out-patient treatment,
according to
an Austrian
study published in the December issue of the
British
Journal of Psychiatry.
Depression is a major mental health problem
among older people, affecting around 12% of people over the age of
64. Evidence shows that a combination of antidepressant medication
and psychological treatments such as cognitive behavioural therapy
can be effective in treating elderly people with depression.
However, there has been less research into how these treatments
should be delivered, and whether it is better to provide them in
patients’ homes or in hospitals.
Researchers studied 60 patients with major
depression, who were aged over 64 and living in Graz, a town in
Austria. Half the participants received home treatment over a
12-month period. Treatment was delivered by a team consisting of
one psychiatrist, two psychologists, and one social worker. The
team visited each patient once or twice a week, or up to 4 times a
week in crisis situations. There was also telephone support
available for the patient and their carer.
The other half of the participants acted as a
control group. They received conventional out-patient care, with
free access to out-patient appointments with psychiatrists. They
also had an initial meeting with a psychologist, where they were
given information about how to access health and social services in
their local area.
All the participants in the study were
assessed for symptoms of depression at the start of the study,
after 3 months and after 12 months. The researchers found that
patients who received home treatment had significantly fewer
symptoms of depression and a better quality of life at 3 months and
12 months.
In the home treatment group, one person was
admitted to a nursing home during the study period. The admission
was temporary and the person was discharged after 27 days. In the
control group, eight people were admitted to a nursing home and
seven stayed there until the end of the study. The total costs of
care per participant were €8,751.44 (about £7,430) for the home
treatment group and €21,031.84 (about £17,855) for the control
group.
Lead researcher Dr Günter Klug said: “Home
treatment was not only associated with lower depression scores and
more positive clinical outcomes, but also with substantially lower
costs of care. Participants in the home treatment group had fewer
admissions to nursing homes and spent fewer days in psychiatric
in-patient care. Because of the successful prevention of admissions
to psychiatric inpatient care and nursing homes, home treatment was
a very effective and cost-effective form of treatment.”
Dr Klug concluded: “The findings from our
trial are very positive and encouraging. Although they need to be
replicated in other settings and with larger samples, our study
supports the case for investing in such services to improve patient
outcomes and reduce costs.”
For further information, please
contact:
Liz Leicester
or Deborah Hart in the Communications
Department.
Telephone: 020 7235 2351 Extensions. 6298 or 6127
References:
Klug G, Hermann G, Fuchs-Nieder B, Panzer M, Haider-Stipacek A, Zapotoczky HG and Priebe S (2010) Effectiveness of home treatment for elderly people with depression: randomised controlled trial, British Journal of Psychiatry, 197: 463-467