Economic evaluations of Internet interventions for mental health: a systematic review

2015 ◽  
Vol 45 (16) ◽  
pp. 3357-3376 ◽  
Author(s):  
T. Donker ◽  
M. Blankers ◽  
E. Hedman ◽  
B. Ljótsson ◽  
K. Petrie ◽  
...  
Keyword(s):  
Mental Health ◽  
Smoking Cessation ◽  
Cost Effective ◽  
Attention Control ◽  
Economic Evaluations ◽  
Control Group ◽  
Controlled Trials ◽  
Wait List ◽  
Internet Interventions

Background.Internet interventions are assumed to be cost-effective. However, it is unclear how strong this evidence is, and what the quality of this evidence is.Method.A comprehensive literature search (1990–2014) in Medline, EMBASE, the Cochrane Central Register of Controlled Trials, NHS Economic Evaluations Database, NHS Health Technology Assessment Database, Office of Health Economics Evaluations Database, Compendex and Inspec was conducted. We included economic evaluations alongside randomized controlled trials of Internet interventions for a range of mental health symptoms compared to a control group, consisting of a psychological or pharmaceutical intervention, treatment-as-usual (TAU), wait-list or an attention control group.Results.Of the 6587 abstracts identified, 16 papers met the inclusion criteria. Nine studies featured a societal perspective. Results demonstrated that guided Internet interventions for depression, anxiety, smoking cessation and alcohol consumption had favourable probabilities of being more cost-effective when compared to wait-list, TAU, group cognitive behaviour therapy (CBGT), attention control, telephone counselling or unguided Internet CBT. Unguided Internet interventions for suicide prevention, depression and smoking cessation demonstrated cost-effectiveness compared to TAU or attention control. In general, results from cost-utility analyses using more generic health outcomes (quality of life) were less favourable for unguided Internet interventions. Most studies adhered reasonably to economic guidelines.Conclusions.Results of guided Internet interventions being cost-effective are promising with most studies adhering to publication standards, but more economic evaluations are needed in order to determine cost-effectiveness of Internet interventions compared to the most cost-effective treatment currently available.

scholarly journals Systematic review and economic modelling of the clinical effectiveness and cost-effectiveness of art therapy among people with non-psychotic mental health disorders

2015 ◽  
Vol 19 (18) ◽  
pp. 1-120 ◽  
Author(s):  
Lesley Uttley ◽  
Alison Scope ◽  
Matt Stevenson ◽  
Andrew Rawdin ◽  
Elizabeth Taylor Buck ◽  
...  
Keyword(s):  
Mental Health ◽  
Cost Effectiveness ◽  
Art Therapy ◽  
Clinical Effectiveness ◽  
Cost Effective ◽  
Mental Health Disorders ◽  
Control Group ◽  
Wait List ◽  
Health Disorders ◽  
The Cost

BackgroundMental health problems account for almost half of all ill health in people under 65 years. The majority are non-psychotic (e.g. depression, anxiety and phobias). For some people, art therapy may provide more profound and long-lasting healing than more standard forms of treatment, perhaps because it can provide an alternative means of expression and release from trauma. As yet, no formal evaluation of art therapy for non-psychotic mental health disorders has been conducted.AimThis review aimed to evaluate evidence for the clinical effectiveness and cost-effectiveness of art therapy for non-psychotic mental health disorders.MethodsComprehensive literature searches for studies examining art therapy in populations with non-psychotic mental health disorders were performed in major health-related and social science bibliographic databases including MEDLINE, EMBASE, The Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, Allied and Complementary Medicine Database (AMED) and Applied Social Sciences Index and Abstracts (ASSIA) from inception up to May 2013. A quantitative systematic review of clinical effectiveness, a qualitative review to explore the acceptability, relative benefits and potential harms, and a cost–utility analysis of studies evaluating cost-effectiveness of art therapy were conducted.ResultsIn the quantitative review, 15 randomised controlled trials (RCTs) were included (n = 777). Meta-analysis was not possible because of clinical heterogeneity and insufficient comparable data on outcome measures across studies. A narrative synthesis reports that art therapy was associated with significant positive changes relative to the control group in mental health symptoms in 10 out of the 15 studies. The control groups varied between studies but included wait-list/no treatment, attention placebo controls and psychological therapy comparators. Four studies reported improvement from baseline but no significant difference between groups. One study reported that outcomes were more favourable in the control group. The quality of included RCTs was generally low. In the qualitative review, 12 cohort studies were included (n = 188 service users;n = 16 service providers). Themes relating to benefits of art therapy for service users included the relationship with the therapist, personal achievement and distraction. Areas of potential harms were related to the activation of emotions that were then unresolved, lack of skill of the art therapist and sudden termination of art therapy. The quality of included qualitative studies was generally low to moderate. In the cost-effectiveness review, a de novo model was constructed and populated with data identified from the clinical review. Scenario analyses were conducted allowing comparisons of group art therapy with wait-list control, group art therapy with group verbal therapy, and individual art therapy versus control. Art therapy appeared cost-effective compared with wait-list control with high certainty, although generalisability to the target population was unclear. Verbal therapy appeared more cost-effective than art therapy but there was considerable uncertainty and a sizeable probability that art therapy was more clinically effective. The cost-effectiveness of individual art therapy was uncertain and dependent on assumptions regarding clinical benefit and duration of benefit.ConclusionsFrom the limited available evidence, art therapy was associated with positive effects when compared with a control in a number of studies in patients with different clinical profiles, and it was reported to be an acceptable treatment and was associated with a number of benefits. Art therapy appeared to be cost-effective compared with wait-list but further studies are needed to confirm this finding as well as evidence to inform future cost-effective analyses of art therapy versus other treatments.Study registrationThe study is registered as PROSPERO CRD42013003957.FundingThe National Institute for Health Research Health Technology Assessment programme.

scholarly journals A systematic review of trial-based economic evaluations of internet- and mobile-based interventions for substance use disorders

2019 ◽  
Author(s):  
Claudia Buntrock ◽  
Fanny Kählke ◽  
Filip Smit ◽  
David Daniel Ebert
Keyword(s):  
Systematic Review ◽  
Substance Use ◽  
Cost Effectiveness ◽  
Substance Use Disorders ◽  
Cost Effective ◽  
Economic Evaluations ◽  
Control Group ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Study Results

Abstract Background Substance use disorders (SUDs) contribute significantly to global rates of morbidity and mortality. Internet- and mobile-based interventions (IMIs) have been suggested as an adjunct to face-to-face health services. However, the evidence for the cost-effectiveness of IMIs for SUDs is scant. Methods A comprehensive literature search in PubMed, PsycINFO, the Cochrane Central Register of Controlled Trials, NHS Economic Evaluations Database, NHS Health Technology Assessment Database, Office of Health Economics Evaluations Database and EconLit was conducted. We included economic evaluations alongside randomized controlled trials of IMIs for SUDs compared with a control group. Results Of 1687 abstracts identified, 11 studies met the inclusion criteria. Targeted conditions were alcohol use disorder (four studies) and tobacco smoking (five studies) whereas two studies included any SUD. Cost-effectiveness results demonstrated that IMIs had a firm probability of being more cost-effective than TAU (e.g. less costs per additional abstinent person). Compared with (online) psycho-education, evidence towards an additional benefit of IMIs was less clear. Regarding cost-utility (e.g. costs per quality-adjusted life year gained), except for one study, results suggested that TAU and online psycho-education would probably be more preferable than IMIs. Quality of study reporting was at least adequate. Conclusions The likelihood of IMIs being more cost-effective than TAU looks promising but more economic evaluations are needed in order to determine the economic merit of IMIs. With an increasing pressure on health care budgets, strategies to disseminate effective interventions at affordable costs are required. This review suggests that IMIs might carry that promise and have potential as a cost-effective strategy to scale-up existing evidence-based treatments for SUDs. Systematic review registration The systematic review has been registered in the PROSPERO database (no. CRD42018099486).

scholarly journals Effect of Hope-oriented group counseling on mental health of infertile women with failed IVF cycles: a randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Roya Rahimi ◽  
Shirin Hasanpour ◽  
Mojgan. Mirghafourvand ◽  
Khalil Esmaeilpour
Keyword(s):  
Mental Health ◽  
Confidence Interval ◽  
Group Counseling ◽  
Controlled Trial ◽  
Intervention Group ◽  
Mean Difference ◽  
Control Group ◽  
The Mean ◽  
And Control

Abstract Background Considering the prevalence of infertility in the community and the consequences of failure of infertility treatments on women’s mental health, interventions that can control stress, anxiety and depression in infertile women with a history of IVF failure will be very helpful. This study aimed to determine the effects of hope-oriented group counseling on mental health (primary outcome) and quality of life (QoL) (secondary outcome) of women with failed IVF cycles. Method This randomized controlled trial was conducted on 60 women with failed IVF cycles visiting Infertility Clinic at Al-Zahra Teaching Hospital of Tabriz- Iran. Participants were allocated to the intervention group (n = 30) and control group (n = 30) based on a randomized block design. Hope-oriented group counseling was provided to the intervention group in six 45–60 min sessions (once a week). The control group only received routine care to undergo another IVF cycle. The Depression Anxiety Stress Scale-21 (DASS-21) and the SF-12 Quality of Life Scale were filled out by interviewing the participants before the intervention and one week and one month after the intervention. After intervention 26 participants in each group were included in the analysis. Results There was no significant difference between the intervention and control groups in the socio-demographic profile of participants (P > 0.05). The post-intervention mean score of stress (adjusted mean difference = − 1.7, 95% confidence interval: − 3.2 to − 0.3, P = 0.018) and depression (adjusted mean difference = − 1.3, 95% confidence interval: − 4.7 to − 1.5, P < 0.001) was significantly lower in the intervention group compared to the control. Although the mean anxiety score was lower in the intervention group compared to the control, the difference between them was not statistically significant (adjusted mean difference = − 1.1, 95% confidence interval: − 2.6 to 0.4, P = 0.153). The mean score of QoL was significantly higher in the intervention group than that of the control group (adjusted mean difference = 6.9, 95% confidence interval: 5.1 to 8.8, P < 0.001). Conclusion Hope-oriented group counseling was effective in reducing stress and depression and improving QoL in women with failed IVF cycles. It is recommended to use this counseling approach, along with other methods, to improve the mental health of women with failed IVF cycles. Trial registration TCT Registration Number: TCTR 20191017003, registered on October 17, 2019.

scholarly journals The Effect of Traditional Korean Medicine for Chemotherapy-Induced Hand-Foot Syndrome in Cancer Patients: Review

2021 ◽  
Vol 42 (3) ◽  
pp. 340-350
Author(s):  
Eun-ji Kim ◽  
Chan-ran Park ◽  
Chang-gue Son ◽  
Jung-hyo Cho ◽  
Nam-hun Lee
Keyword(s):  
Cancer Patients ◽  
Common Adverse Effect ◽  
Control Group ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Research Information ◽  
Traditional Korean Medicine ◽  
Korean Medicine ◽  
Hand Foot Syndrome

Objectives: Hand-foot syndrome (HFS) is a common adverse effect of chemotherapy in cancer patients. This review synthesizes research results to assess the effect of traditional Korean medicine (TKM) on HFS in cancer patients.Methods: Four databases (PubMed, The Cochrane Central Register of Controlled Trials, Research Information Sharing Service, China National Knowledge Infrastructure) were searched for randomized controlled trials (RCTs) to assess the effects of TKM on HFS. The effects and quality of RCTs were assessed with the Cochrane risk of bias (ROB) tool.Results: Six RCTs met our study criteria. In all six, TKM showed improvement in HFS symptoms as well as quality of life scores when compared to the control group. However, the methodological quality of RCTs was relatively low due to the unclear or high ROB.Conclusions: TKM would be helpful to patients with HFS after chemotherapy. To clarify the clinical efficacy of TKM, well-designed studies are required in the future.

scholarly journals The economics of mental health in the workplace: what do we know and where do we go?

2007 ◽  
Vol 16 (4) ◽  
pp. 294-298 ◽  
Author(s):  
David McDaid
Keyword(s):  
Mental Health ◽  
Grey Literature ◽  
Cost Effective ◽  
Evidence Base ◽  
Poor Mental Health ◽  
Health Interventions ◽  
Economic Evaluations ◽  
Policy Makers ◽  
Productivity Losses ◽  
Mental Health Interventions

AbstractTo provide an overview of the economic impact of poor mental health in the workplace and assess the extent to which economic evaluation has been used to further the case for investment in workplace based mental health programmes. Rapid scoping review of published and grey literature. The socio-economic costs of poor mental health in the workplace are substantial but conservative, as few studies have included productivity losses from work cutback, as well as absenteeism. While few economic evaluations of workplace based mental health interventions were identified, the available evidence base suggests that they have the potential to be highly cost effective. Much of this evidence may be from the US and be less applicable elsewhere; it may also have been solely published in company documents making assessment of methodological quality difficult. The potential economic case for workplace based mental health interventions appears good. More collaboration between policy makers and the private sector would help facilitate rigorous and transparent economic evaluations. A number of evaluations are planned. The challenge is to build on these initiatives, in order to address what remains a major gap in our knowledge on the economics of mental health.

The economic benefits of rehabilitation for neurological conditions

2020 ◽  
pp. 23-30
Author(s):  
Rory J. O’Connor
Keyword(s):  
Psychological Functioning ◽  
Cost Effective ◽  
Economic Benefits ◽  
Economic Evaluations ◽  
Healthcare Intervention ◽  
Effective Interventions ◽  
Neurological Conditions ◽  
Economic Analyses

Rehabilitation programmes are highly cost-effective interventions that restore people’s independence, dignity, and quality of life. In the past there was an impression that they appeared expensive, which resulted in a lack of enthusiasm to develop them by funding bodies and commissioners. However, the evidence demonstrating the long-term cost-effectiveness of rehabilitation is robust. Many people with long-term neurological conditions will live for many years after the onset of the condition and investment in their physical and psychological functioning early on will, over that person’s lifetime, will result in substantial savings. Nevertheless, calculating economic evaluations can be complicated and the correct measure must be chosen to identify the change produced by the rehabilitation intervention. These data must then be handled appropriately, and any ancillary costs included. The economic impact of the rehabilitation programme is wider than a purely healthcare intervention and will include potential earnings and reduced costs to social care. The economic analyses will also include housing, education, and vocational outcomes, and the effect of the long-term condition on family members who may have a caring role.

scholarly journals The Effectiveness of Moxibustion: An Overview During 10 Years

2011 ◽  
Vol 2011 ◽  
pp. 1-19 ◽  
Author(s):  
Song-Yi Kim ◽  
Younbyoung Chae ◽  
Seung Min Lee ◽  
Hyejung Lee ◽  
Hi-Joon Park
Keyword(s):  
Meta Analysis ◽  
Breech Presentation ◽  
Control Group ◽  
Controlled Trials ◽  
Control Groups ◽  
Randomized Controlled ◽  
Language Restriction ◽  
Digestive Disorders ◽  
General Care

Moxibustion has been used to treat various types of disease. However, there is still insufficient evidence regarding its effectiveness. This study was performed to summarize and evaluate the effectiveness of moxibustion. A search was performed for all randomized controlled trials in PubMed between January 1998 and July 2008 with no language restriction. The results yielded 47 trials in which six moxibustion types were applied to 36 diseases ranging from breech presentation to digestive disorders. Moxibustion was compared to three types of control group: general care, Oriental medical therapies or waiting list. Moxibustion was superior to the control in 14 out of 54 control groups in 46 studies. There were no significant differences among groups in 7 studies, and the outcome direction was not determined in 33 studies. Seven studies were included in a meta-analysis. Moxibustion was more effective than medication in two ulcerative colitis studies (relative risk (95% CI), 2.20 (1.37, 3.52),P= .001,I2= 0%). Overall, our results did not support the effectiveness of moxibustion in specific diseases due to the limited number and low quality of the studies and inadequate use of controls. In order to provide appropriate evidence regarding the effectiveness of moxibustion, more rigorous clinical trials using appropriate controls are warranted.

scholarly journals Effectiveness of interventions for adults with mild to moderate intellectual disabilities and mental health problems: systematic review and meta-analysis

2016 ◽  
Vol 209 (6) ◽  
pp. 469-474 ◽  
Author(s):  
Nadine Koslowski ◽  
Kristina Klein ◽  
Katrin Arnold ◽  
Markus Kösters ◽  
Matthias Schützwohl ◽  
...  
Keyword(s):  
Mental Health ◽  
Intellectual Disability ◽  
Intellectual Disabilities ◽  
Mental Health Problems ◽  
Meta Analysis ◽  
Health Problems ◽  
System Level ◽  
Controlled Trials ◽  
Moderate Intellectual Disability

BackgroundThere is a lack of available evidence in relation to the effectiveness of interventions for adults with mild to moderate intellectual disability and mental health problems.AimsTo evaluate the efficacy of interventions for adults with mild to moderate intellectual disabilities and co-occurring mental health problems.MethodAn electronic literature search of the databases Medline, EMBASE, PsycINFO and EBM Reviews aimed at identifying randomised controlled trials (RCTs) and controlled trials testing any type of intervention (psychotherapy, biological or system level) for people with mild to moderate intellectual disabilities (IQ score 35–69) targeting comorbid mental health problems. Additionally a meta-analysis was conducted.ResultsTwelve studies met the inclusion criteria. No significant effect was found for the predefined outcome domains behavioural problems, depression, anxiety, quality of life and functioning. The effect size for depression (d = 0.49) was moderate but non-significant. Quality of studies was moderate and heterogeneity was high.ConclusionsThere is no compelling evidence supporting interventions aiming at improving mental health problems in people with mild to moderate intellectual disability. The number of available trials is too low for definite conclusions. Some interventions are promising and should be evaluated further in larger and more rigorous trials.

Quality of Life and Mental Health in Brazilian Women Treated for Invasive Carcinoma of the Cervix

2014 ◽  
Vol 24 (4) ◽  
pp. 794-799
Author(s):  
Gabriela A. Caixeta ◽  
Emma E. C. Castro ◽  
Agnaldo L. Silva-Filho ◽  
Fernando M. Reis ◽  
José R. Cunha-Melo ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Life Events ◽  
General Health ◽  
Invasive Carcinoma ◽  
Short Form ◽  
General Health Questionnaire ◽  
Control Group ◽  
History Of

ObjectiveThe objective of this study was to compare the quality of life (QOL) and mental health (MH) of women surviving at least 2 years after treatment for invasive carcinoma of the cervix by radical hysterectomy (RH), chemotherapy and/or radiotherapy, or by surgery followed by adjuvant therapy (RH + chemotherapy and/or radiotherapy). The QOL/MH of a control group of women with no history of malignancy was also assessed for comparison with the treated groups.MethodsThe levels of QOL and MH were assessed in 114 Brazilian women (57 patients with an average of 4 years since treatment completion and 57 control subjects). The 36-item Medical Outcomes Study Short-Form Health Survey, the State-Trait Anxiety Inventory, the 12-item General Health Questionnaire, the Life Events Inventory, and a general survey for the assessment of sociodemographic data were applied to each participant of the study.ResultsNo differences were noted among the 3 treatment groups or between these and the control group concerning the levels of QOL (either physical or MH aspects), anxiety, general health, or life events. However, lower levels of anxiety were detected in cancer survivors when compared with the control group (P = 0.035).ConclusionsAfter at least 2 years, the QOL and the MH of Brazilian women treated for invasive carcinoma of the cervix were similar to those of women without malignancy and were not affected by the modality of treatment.

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