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Economic evaluation of a dietary intervention for adults with major depression (the “SMILES” trial)
Chatterton et al. (2018) collected data from and evaluated the cost-effectiveness of the SMILES trial, which demonstrated the efficacy of dietary interventions (a significant improvement in Montgomery-Asberg Depression Rating Scale scores was seen in the diet support group compared to a control group over 12 weeks). The trial involved participants being randomized into either seven sessions with a dietician for dietary support, or an intensity-matched social support (befriending) control condition. Evaluating the costs from health sector and societal perspectives, data on food and travel costs, medications, medical services, workplace absenteeism and presenteeism were collected using a resource-use questionnaire. Standard Australian unit costs for 2013/2014 were applied before incremental cost-effectiveness ratios (ICERs) were calculated by dividing the average cost difference between groups by the difference in average Quality Adjusted Life Years (QALY, the primary outcome of the SMILES trial). Compared with the social support condition, average total health sector costs were $856 lower and average societal costs were $2591 lower for those receiving dietary support. These differences were driven by lower costs arising from fewer allied and other health professional visits and lower costs of unpaid productivity. Although significant differences in mean QALYs were not found between groups, 68% and 69% of bootstrap iterations showed the dietary support intervention was dominant, meaning additional QALYs at a cheaper price, from the healthcare sector and societal perspectives. Therefore Chatterton and researchers (2018) found the dietary support intervention likely to be cost-effective as an adjunctive treatment for depression. [NPID: SMILES, dietary interventions, social support, depression, cost-effective]
Year: 2018
