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Cost-effectiveness of a preferred intensity exercise programme for young people with depression compared with treatment as usual: an economic evaluation alongside a clinical trial in the UK [with consumer summary]
Turner D, Carter T, Sach T, Guo B, Callaghan P
BMJ Open 2017 Nov;7(11):e016211
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVES: To assess the cost-effectiveness of preferred intensity exercise programme for young people with depression compared with a treatment as usual control group. DESIGN: A 'within trial' cost-effectiveness and cost-utility analysis conducted alongside a randomised controlled trial. The perspective of the analysis was the UK National Health Service and social services. SETTING: The intervention was provided in a community leisure centre setting. PARTICIPANTS: 86 young people aged 14 to 17 years attending Tier 2 and Tier 3 CAMHS (Child and Adolescent Mental Health Services) outpatient services presenting with depression. INTERVENTIONS: The intervention comprised 12 separate sessions of circuit training over a 6-week period. Sessions were supervised by a qualified exercise therapist. Participants also received treatment as usual. The comparator group received treatment as usual. RESULTS: We found improvements in the Children's Depression Inventory-2 (CDI-2) and estimated cost-effectiveness at 61 per point improvement in CDI-2 for the exercise group compared with control. We found no evidence that the exercise intervention led to differences in quality-adjusted life years (QALY). QALYs were estimated using the EQ-5D-5L (5-level version of EuroQol-5 dimension). CONCLUSIONS: There is evidence that exercise can be an effective intervention for adolescents with depression and the current study shows that preferred intensity exercise could also represent a cost-effective intervention in terms of the CDI-2. TRIAL REGISTRATION NUMBER: NCT01474837.
Reproduced with permission from the BMJ Publishing Group.

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