Cost-Effectiveness of Therapist-Guided Internet-Based Cognitive Behavioral Therapy for Stress-Related Disorders: Secondary Analysis of a Randomized Controlled Trial (Preprint)

BACKGROUND Stress-related disorders are associated with significant suffering, functional impairment, and high societal costs. Internet-based cognitive behavioral therapy (ICBT) is a promising treatment for stress-related disorders but has so far not been subjected to health economic evaluation. OBJECTIVE The objective of this study was to evaluate the cost-effectiveness and cost-utility of ICBT for patients with stress-related disorders in the form of adjustment disorder (AD) or exhaustion disorder (ED). We hypothesized that ICBT, compared with a waitlist control (WLC) group, would generate improvements at low net costs, thereby making it cost-effective. METHODS Health economic data were obtained in tandem with a randomized controlled trial of a 12-week ICBT in which patients (N=100) were randomized to an ICBT (n=50) or a WLC (n=50) group. Health outcomes and costs were surveyed pre- and posttreatment. We calculated incremental cost-effectiveness ratios (ICERs) based on remission rates and incremental cost-utility ratios (ICURs) based on health-related quality of life. Bootstrap sampling was used to assess the uncertainty of our results. RESULTS The ICER indicated that the most likely scenario was that ICBT led to higher remission rates compared with the WLC and was associated with slightly larger reductions in costs from pre- to posttreatment. ICBT had a 60% probability of being cost-effective at a willingness to pay (WTP) of US $0 and a 96% probability of being cost-effective at a WTP of US $1000. The ICUR indicated that ICBT also led to improvements in quality of life at no net societal cost. Sensitivity analyses supported the robustness of our results. CONCLUSIONS The results suggest that ICBT is a cost-effective treatment for patients suffering from AD or ED. Compared with no treatment, ICBT for these patients yields large effects at no or minimal societal net costs. CLINICALTRIAL ClinicalTrials.gov NCT02540317; https://clinicaltrials.gov/ct2/show/NCT02540317

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Cost-Effectiveness of Therapist-Guided Internet-Based Cognitive Behavioral Therapy for Stress-Related Disorders: Secondary Analysis of a Randomized Controlled Trial

Journal of Medical Internet Research ◽

10.2196/14675 ◽

2019 ◽

Vol 21 (9) ◽

pp. e14675

Author(s):

Elin Lindsäter ◽

Erland Axelsson ◽

Sigrid Salomonsson ◽

Fredrik Santoft ◽

Brjánn Ljótsson ◽

...

Keyword(s):

Quality Of Life ◽

Health Economic ◽

Cost Effectiveness ◽

Behavioral Therapy ◽

Controlled Trial ◽

Cost Effective ◽

Cost Utility ◽

Randomized Controlled ◽

Remission Rates

Background Stress-related disorders are associated with significant suffering, functional impairment, and high societal costs. Internet-based cognitive behavioral therapy (ICBT) is a promising treatment for stress-related disorders but has so far not been subjected to health economic evaluation. Objective The objective of this study was to evaluate the cost-effectiveness and cost-utility of ICBT for patients with stress-related disorders in the form of adjustment disorder (AD) or exhaustion disorder (ED). We hypothesized that ICBT, compared with a waitlist control (WLC) group, would generate improvements at low net costs, thereby making it cost-effective. Methods Health economic data were obtained in tandem with a randomized controlled trial of a 12-week ICBT in which patients (N=100) were randomized to an ICBT (n=50) or a WLC (n=50) group. Health outcomes and costs were surveyed pre- and posttreatment. We calculated incremental cost-effectiveness ratios (ICERs) based on remission rates and incremental cost-utility ratios (ICURs) based on health-related quality of life. Bootstrap sampling was used to assess the uncertainty of our results. Results The ICER indicated that the most likely scenario was that ICBT led to higher remission rates compared with the WLC and was associated with slightly larger reductions in costs from pre- to posttreatment. ICBT had a 60% probability of being cost-effective at a willingness to pay (WTP) of US $0 and a 96% probability of being cost-effective at a WTP of US $1000. The ICUR indicated that ICBT also led to improvements in quality of life at no net societal cost. Sensitivity analyses supported the robustness of our results. Conclusions The results suggest that ICBT is a cost-effective treatment for patients suffering from AD or ED. Compared with no treatment, ICBT for these patients yields large effects at no or minimal societal net costs. Trial Registration ClinicalTrials.gov NCT02540317; https://clinicaltrials.gov/ct2/show/NCT02540317

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“As du Coeur” study: a randomized controlled trial on quality of life impact and cost effectiveness of a physical activity program in patients with cardiovascular disease

BMC Cardiovascular Disorders ◽

10.1186/s12872-018-0973-3 ◽

2018 ◽

Vol 18 (1) ◽

Cited By ~ 2

Author(s):

Laurent Bailly ◽

Philippe Mossé ◽

Stéphane Diagana ◽

Marion Fournier ◽

Fabienne d’Arripe-Longueville ◽

...

Keyword(s):

Quality Of Life ◽

Physical Activity ◽

Cardiovascular Disease ◽

Randomized Controlled Trial ◽

Cost Effectiveness ◽

Controlled Trial ◽

Randomized Controlled ◽

Activity Program ◽

Life Impact

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Efficacy of Cognitive-Behavioral Therapy (CBT) on aggressive behavior in children with ADHD and emotion dysregulation: study protocol of a randomized controlled trial

10.21203/rs.3.rs-446296/v1 ◽

2021 ◽

Author(s):

Cécile Vacher ◽

Lucia Romo ◽

Diane Purper-Ouakil

Keyword(s):

Quality Of Life ◽

Randomized Controlled Trial ◽

Executive Function ◽

Cognitive Behavioral Therapy ◽

Behavioral Therapy ◽

Controlled Trial ◽

Cognitive Behavioral ◽

Children With Adhd ◽

Randomized Controlled

Abstract • Background: Attention Deficit Hyperactivity Disorder (ADHD) is frequently associated with emotional dysregulation (ED). ED is characterized by excessive and inappropriate emotional reactions compared to social norms, uncontrolled and rapid shifts in emotion, and attention focused on emotional stimuli. Few studies have evaluated non-pharmacological interventions to improve ED in children with ADHD. The current randomized controlled trial assesses the efficacy of a Cognitive-Behavioral Therapy (CBT) intervention compared with a theater-based intervention (TBI) in children with ADHD and ED. • Methods: Sixty-eight 7 to 13-year-old children with ADHD and ED will be recruited and randomly assigned to the CBT or TBI group. CBT aims to reduce ED by teaching anger management strategies. TBI seeks to reduce ED by improving emotion understanding and expression through mimics and movement. In both groups, children participate in 15 one-hour sessions, and parents participate in 8 sessions of a parent management program. The primary outcome measure is the change in the “Aggression” sub-score of the Child Behavior Checklist (CBCL). Secondary outcome measures include overall impairment (Children’s Global Assessment Scale, Strengths and Difficulties Questionnaire), personality profile (Hierarchical Personality Inventory for Children), executive function (Behavioral Rating Inventory of Executive Function), quality of life (Kidscreen-27), parental stress (Parenting Stress Index, 4th edition), parental depression (Beck Depression Inventory-II), and impact of child disorders on the quality of the family life (Parental Quality of Life and Developmental Disorder). • Discussion: Children with ADHD and ED are at risk of functional impairment and poor outcomes, and have specific therapeutic needs. This randomized controlled trial wants to assess non-pharmacological treatment options for this population. • Trial registration:Clinicaltrials.gov. Number: NCT03176108. Registered on June 5, 2017

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Efficacy and cost-utility of the eHealth application ‘Oncokompas’, supporting patients with incurable cancer in finding optimal palliative care, tailored to their quality of life and personal preferences: a study protocol of a randomized controlled trial

BMC Palliative Care ◽

10.1186/s12904-019-0468-8 ◽

2019 ◽

Vol 18 (1) ◽

Cited By ~ 4

Author(s):

Anouk S. Schuit ◽

Karen Holtmaat ◽

Nienke Hooghiemstra ◽

Femke Jansen ◽

Birgit I. Lissenberg-Witte ◽

...

Keyword(s):

Quality Of Life ◽

Palliative Care ◽

Randomized Controlled Trial ◽

Controlled Trial ◽

Intervention Group ◽

Cost Utility ◽

Control Group ◽

Incurable Cancer ◽

Randomized Controlled

Abstract Background Patients with incurable cancer have to deal with a wide range of symptoms due to their disease and treatment, influencing their quality of life. Nowadays, patients are expected to adopt an active role in managing their own health and healthcare. Oncokompas is an eHealth self-management application developed to support patients in finding optimal palliative care, tailored to their quality of life and personal preferences. A randomized controlled trial will be carried out to determine the efficacy and cost-utility of Oncokompas compared to care as usual. Methods 136 adult patients with incurable lung, breast, colorectal and head and neck cancer, lymphoma and glioma, will be included. Eligible patients have no curative treatment options and a prognosis of at least three months. Patients will be randomly assigned to the intervention group or the control group. The intervention group directly has access to Oncokompas alongside care as usual, while the waiting list control group receives care as usual and will have access to Oncokompas after three months. The primary outcome measure is patient activation, which can be described as a patient’s knowledge, skills and confidence to manage his or her own health and healthcare. Secondary outcome measures comprise self-efficacy, health-related quality of life, and costs. Measures will be assessed at baseline, two weeks after randomization, and three months after the baseline measurement. Discussion This study will result in knowledge on the efficacy and cost-utility of Oncokompas among patients with incurable cancer. Also, more knowledge will be generated into the need for and costs of palliative care from a societal and healthcare perspective. Trial registration Netherlands Trial Register identifier: NTR 7494. Registered on 24 September 2018.

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