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Cost-effectiveness of a smartphone-based personalized lifestyle intervention for symptoms of depression in primary
E M Jagtenberg1, S A Ligthart2, O G Muilwijk2
1Department of Primary and Community Care, Radboud University Medical Center Research Institute for Medical Innovation, Nijmegen, the Netherlands. eline.jagtenberg@radboudumc.nl.
Background:
Depression is common and mostly managed in primary care. In the Netherlands, general practitioners (GPs) and mental health nurses (GP-MHNs) generally start with education and lifestyle advice, yet the latter remains underused despite evidence of its effectiveness. Smartphone-based eHealth tools may help integrate lifestyle interventions into routine care by offering personalized support and monitoring. This study evaluates the (cost-)effectiveness of a Personalized eHealth Lifestyle Intervention (PLI) delivered via a smartphone app for patients with symptoms of depression in primary care.
Methods:
This multicenter, cluster-randomized controlled trial will be conducted in Dutch general practices. Practices will be randomized (1:1), stratified by region and area-level socioeconomic status, into two groups: (1) intervention group including care as usual plus the PLI, or (2) control group including care as usual plus a monitoring app. Within the PLI, patients will use an app for 6 months to set lifestyle goals, monitor progress in lifestyle behavior, and track symptoms of depression and anxiety. GPs and GP-MHNs will have access to patient progress through a web-based version. Control group patients will use a similar app for symptom tracking only. The primary outcome is the change in severity of symptoms of depression assessed with the Patient Health Questionnaire-9 (PHQ-9). Secondary outcomes include lifestyle behaviors, satisfaction with lifestyle, anxiety symptoms, patient satisfaction with treatment by GP and GP-MHNs, mental health-related quality of life, social support, use of antidepressants, use of anxiolytics, and utilization of medical and mental health services. Cost-effectiveness will also be evaluated. A total of 105 patients per arm (PHQ-9 ≥ 5) will be recruited.
Discussion:
The results of this study will provide valuable insights into the clinical and economic impact of a digital lifestyle support tool. This trial aims to contribute to more accessible, personalized, sustainable, and cost-effective care for people with symptoms of depression in primary care.
Trial Registration:
ClinicalTrials.gov NCT07022184. Registered on June 22, 2025.
