scholarly journals Cost-effectiveness of ‘screen-and-treat’ interventions for post-traumatic stress disorder following major incidents

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e049472
Author(s):  
Nicole Hogan ◽  
Martin Knapp ◽  
David McDaid ◽  
Mark Davies ◽  
Chris R Brewin
Keyword(s):  
Cost Effectiveness ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Cost Effective ◽  
Major Incident ◽  
Post Traumatic Stress ◽  
Treatment As Usual ◽  
Major Incidents ◽  
Post Traumatic

ObjectivesPost-traumatic stress disorder (PTSD) is commonly experienced in the aftermath of major incidents such as terrorism and pandemics. Well-established principles of response include effective and scalable treatment for individuals affected by PTSD. In England, such responses have combined proactive outreach, screening and evidence-based interventions (a ‘screen-and-treat’ approach), but little is known about its cost-effectiveness. The objective of this paper is to report the first systematic attempt to assess the cost-effectiveness of this approach.MethodsA decision modelling analysis was undertaken to estimate the costs per quality-adjusted life-year (QALY) gained from a screen-and-treat approach compared with treatment-as-usual, the latter involving identification of PTSD by general practitioners and referral to psychological therapy services. Model input variables were drawn from relevant empirical studies in the context of terrorism and the unit costs of health and social care in England. The model was run over a 5-year time horizon for a hypothetical cohort of 1000 exposed adults from the perspective of the National Health Service and Personal Social Services in England.ResultsThe incremental cost per QALY gained was £7931. This would be considered cost-effective 88% of the time at a willingness-to-pay threshold of £20 000 per QALY gained, the threshold associated with the National Institute for Health and Care Excellence in England. Sensitivity analysis confirmed this result was robust.ConclusionsA screen-and-treat approach for identifying and treating PTSD in adults following terrorist attacks appears cost-effective in England compared with treatment-as-usual through conventional primary care routes. Although this finding was in the context of terrorism, the implications might be translatable into other major incident-related scenarios including the current COVID-19 pandemic.

scholarly journals Cost effectiveness of interventions for Post-Traumatic Stress Disorders following major incidents including terrorism and pandemics

2020 ◽  
Author(s):  
Nicole Hogan ◽  
Martin Knapp ◽  
David McDaid ◽  
Mark Davies ◽  
Chris R. Brewin
Keyword(s):  
Cost Effectiveness ◽  
Traumatic Stress ◽  
Cost Effective ◽  
Stress Disorders ◽  
Major Incident ◽  
Post Traumatic Stress ◽  
Treatment As Usual ◽  
Major Incidents ◽  
Post Traumatic ◽  
The Impact

AbstractBackgroundPost-traumatic stress disorder (PTSD) is commonly experienced in the aftermath of major incidents such as terrorism and pandemics. Well-established principles of response include effective and scalable treatment for individuals affected by PTSD. In England, such responses have combined proactive outreach, screening, and evidence-based interventions (a “screen-and-treat” approach), but little is known about the cost-effectiveness of this approach.MethodsA decision modelling analysis was undertaken to estimate the costs per quality adjusted life year (QALY) gained from a screen-and-treat approach compared to treatment-as-usual. Model input variables were drawn from relevant empirical studies in the context of terrorism and the unit costs of health and social care in England. The model was run over a five-year time horizon for a hypothetical cohort of 1,000 exposed adults from the perspective of the National Health Service and Personal Social Services in England.ResultsThe incremental cost per QALY gained was £8,297. This would be considered cost-effective 95% of the time at a willingness-to-pay threshold of £20,000 per QALY gained, the threshold associated with NICE. Sensitivity analysis confirmed this result was robust.ConclusionsA screen-and-treat approach for identifying and treating PTSD in adults following major incidents appears cost-effective in England compared to treatment-as-usual through conventional primary care routes. This finding was in the context of terrorism but can be translatable into other major-incident related scenarios including the current COVID-19 pandemic in lieu of data on the impact of this pandemic.

scholarly journals Cost-effectiveness of psychological treatments for post-traumatic stress disorder in adults

PLoS ONE ◽  
2020 ◽  
Vol 15 (4) ◽  
pp. e0232245 ◽  
Author(s):  
Ifigeneia Mavranezouli ◽  
Odette Megnin-Viggars ◽  
Nick Grey ◽  
Gita Bhutani ◽  
Jonathan Leach ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Post Traumatic Stress ◽  
Psychological Treatments ◽  
Post Traumatic

scholarly journals Effectiveness, Cost-Utility, and Safety of Neurofeedback Self-Regulating Training in Patients with Post-Traumatic Stress Disorder: A Randomized Controlled Trial

Healthcare ◽  
2021 ◽  
Vol 9 (10) ◽  
pp. 1351
Author(s):  
Jungtae Leem ◽  
Moon Joo Cheong ◽  
Hyeryun Lee ◽  
Eun Cho ◽  
So Young Lee ◽  
...  
Keyword(s):  
Adverse Events ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Controlled Trial ◽  
Cost Effective ◽  
Cost Utility ◽  
Control Group ◽  
Post Traumatic Stress ◽  
Post Traumatic

Post-traumatic stress disorder (PTSD) is characterized by neurophysiological and psycho-emotional problems after exposure to trauma. Several pharmacological and psychotherapy limitations, such as adverse events and low adherence, increase the need for alternative therapeutic options. Neurofeedback is widely used for PTSD management. However, evidence of its clinical efficacy is lacking. We conducted a randomized, waitlist-controlled, assessor-blinded clinical trial to assess the effectiveness, cost-utility, and safety of 16 sessions of neurofeedback on people with PTSD for eight weeks. Eleven participants were allocated to each group. One and two subjects dropped out from the neurofeedback and control groups, respectively. The primary outcome was PTSD symptom change evaluated using the PTSD Checklist-5 (PCL-5-K). The PCL-5-K levels improved more in the neurofeedback group (44.3 ± 10.8 to 19.4 ± 7.75) than in the control group (35.1 ± 18.5 to 31.0 ± 14.92). The change value was significantly improved in the neurofeedback group (24.90 ± 13.13 vs. 4.11 ± 9.03). Secondary outcomes such as anxiety, depression, insomnia, and quality of life were also improved. In an economic analysis using EuroQol-5D, the incremental cost-per-quality-adjusted life-year was approximately $15,600, indicating acceptable cost-utility. There were no adverse events in either group. In conclusion, neurofeedback might be a useful, cost-effective, and safe intervention for PTSD management.

scholarly journals Cost‐effectiveness of psychological interventions for children and young people with post‐traumatic stress disorder

2019 ◽  
Vol 61 (6) ◽  
pp. 699-710
Author(s):  
Ifigeneia Mavranezouli ◽  
Odette Megnin‐Viggars ◽  
David Trickey ◽  
Richard Meiser‐Stedman ◽  
Caitlin Daly ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Young People ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Psychological Interventions ◽  
Post Traumatic Stress ◽  
Children And Young People ◽  
Post Traumatic

scholarly journals Healing Post-Traumatic Stress Disorder & Traumatic Brain Injury

2021 ◽  
pp. 1-9
Author(s):  
Janine Regan Sinclair ◽  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Critical Factor ◽  
Cost Effective ◽  
Post Traumatic Stress ◽  
Digital World ◽  
Post Traumatic

Post-Traumatic Stress Disorder (PTSD) is a silent psychological wound and is a major problem for veterans and active servicemen and women alike. The sufferer battles with a sense of identity loss that can leave them angry, depressed, emotionally imbalanced and often empty inside. With an average of 20 veterans committing suicide daily, there is room for improvement in the way treatment is offered to them [1]. In a digital world, we need to move with the times and offer digital therapy, so easy to access that victims need only pick up their cell phone to help themselves. Conventional treatment methods focus on the mind-body connection, which is only a part of the solution; a critical factor in healing PTSD is the damage caused to the human spirit or psyche, which is described in this paper as ‘soul fragmentation’. This is where the saying ‘beside myself ’ comes from, as victims often feel a sense of disassociation or feeling like they are disorientated in some way even though they are still functioning; therefore a new approach needs to be taken if we are to recover the victim’s missing identity. This paper explains a new treatment for Post-Traumatic Stress Disorder and Traumatic Brain Injury, incorporating the new science on the block, ‘The Science of Consciousness’. The system includes a four-step Post-Traumatic Growth program that combines a combination of techniques, referred to as ‘Crystal Ki Healing’, the brainchild of Janine Regan-Sinclair – The Consciousness Architect. This article illustrates how a set of digital audio programs are a simple cost-effective solution and a 21st Century approach to treating Post-Traumatic Stress Disorder (PTSD) and Traumatic Brain Injury (TBI)

scholarly journals Cost-Effectiveness of Integrating Tobacco Cessation Into Post-Traumatic Stress Disorder Treatment

2015 ◽  
Vol 18 (3) ◽  
pp. 267-274 ◽  
Author(s):  
Paul G. Barnett ◽  
Abra Jeffers ◽  
Mark W. Smith ◽  
Bruce K. Chow ◽  
Miles McFall ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Tobacco Cessation ◽  
Stress Disorder ◽  
Post Traumatic Stress ◽  
Post Traumatic ◽  
Disorder Treatment

A brief behavioural treatment of chronic post-traumatic stress disorder in earthquake survivors: results from an open clinical trial

2003 ◽  
Vol 33 (4) ◽  
pp. 647-654 ◽  
Author(s):  
M. BAŞOĞLU ◽  
M. LIVANOU ◽  
E. ŞALCIOĞLU ◽  
D. KALENDER
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Cost Effective ◽  
Post Traumatic Stress ◽  
Behavioural Treatment ◽  
Cost Effective Treatment ◽  
Minimum Number ◽  
Post Traumatic ◽  
Earthquake Survivors

Background. Natural disasters such as earthquakes affect large numbers of people. Given the extent of the mental health problem following earthquakes, brief, effective and cost-effective treatment interventions are urgently needed. The present study examined whether cognitive-behavioural treatment could be shortened to a minimum number of sessions without undermining its effectiveness in post-traumatic stress disorder (PTSD).Method. The study participants (N=231) were consecutive referrals to five project sites in the earthquake region in Turkey a mean of 13 months after the disaster. A modified behavioural treatment (BT) was used, which involved self-exposure instructions based on an enhancement of ‘sense of control’ rather than a habituation rationale and minimal cognitive interventions. The duration of treatment was variable, involving as many sessions as required for clinical improvement. Survival analysis was used to explore the minimum number of sessions required for clinical improvement, and multiple regression analysis to examine the predictors of outcome.Results. The survivors received a mean of 4·3 sessions. Significant treatment effects and clinically meaningful effect sizes were noted on all measures. The treatment improved all PTSD and depression symptoms. The cumulative proportion of improved cases was 76% after one session and 88% after two sessions. No baseline variable predicted treatment outcome.Conclusions. The modified BT appears to be promising as an effective one- or two-session intervention for earthquake survivors. It may be particularly useful in large-scale disasters as a cost-effective treatment that can be relatively easily disseminated to mass populations. Further research is needed to clarify the possible role of a treatment focus on sense of control in rapid recovery from traumatic stress.

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