Jump Step for Mild to Moderate Major Depressive Disorder

Condition Description – Major depressive disorder (MDD) is an episodic mental disorder, diagnosed using subjective symptoms and medical history. The main clinical features of an episode are depressed mood, and/or markedly diminished interest or pleasure in all, or almost all, activities, most of the day, nearly every day continuously for at least two weeks. In some cases, the symptoms can be chronic and persistent for a long time which means that patients never fully recover from the symptoms. Nonemotional symptoms of MDD, such as fatigue, memory impairment, and sleep disturbance, are often attributed to other medical conditions. 

Current treatment options – Pharmacotherapy is the primary publicly funded and commonly available treatment option for MDD in British Columbia. Pharmacotherapy is an effective treatment for MDD, however the outcome can vary greatly across individuals. The success of pharmacotherapy relies on trial and error. More than 50% of patients taking antidepressants do not respond to the first line medication, and for approximately 30% of individuals, symptoms are still problematic after several trials of different medications. Each medication trial may require up to three months to determine if the patient is responding, and therefore a whole year may elapse before an appropriate medication is identified. 

Description of the Assessed Technology(ies) - The Jump Step program is a group medical visit (GMV) model which combines specific medical advice, physical activity, patient discussions and a targeted educational component. The proposed program is an 8-week program consisting of a once weekly, 2- hour GMVs, delivered through virtual care

Health Technology Assessment Committee’s Findings: 

After reviewing the available evidence, the Health Technology Assessment Committee found:

• A program such has jump step has relatively low costs and risks to patients when compared to conventional treatment such as pharmacotherapy.
• The available evidence while limited supports the use of combined group therapy that provides medical advice, patient discussions, targeted education, and physical activity programs, such as Jump Step, for the treatment of depression.

A program such as jump step is expected to be cost-effective compared to treatment as usual, however the potentially eligible patient population in British Columbia is large. Given the limitations of the evidence, if implementation is considered, both the clinical and cost effectiveness of such programs should be monitored closely with the purpose of generating additional data on outcomes. It will be at the discretion of each health authority and/or relevant organization to assess the value of potential benefits in comparison to the additional implementation costs.