Cost-effectiveness of acceptance and commitment therapy for people living with motor neuron disease, and their health-related quality of life.

Autor: Keetharuth AD; School of Medicine and Population Health, Sheffield Centre for Health and Related Research, University of Sheffield, Sheffield, UK., Gould RL; Division of Psychiatry, University College London, London, UK., McDermott CJ; Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, UK., Thompson BJ; Clinical Trials Research Unit, Sheffield Centre for Health and Related Research, University of Sheffield, Sheffield, UK., Rawlinson C; Division of Psychiatry, University College London, London, UK., Bradburn M; Clinical Trials Research Unit, Sheffield Centre for Health and Related Research, University of Sheffield, Sheffield, UK., Bursnall M; Clinical Trials Research Unit, Sheffield Centre for Health and Related Research, University of Sheffield, Sheffield, UK., Kumar P; Clinical Trials Research Unit, Sheffield Centre for Health and Related Research, University of Sheffield, Sheffield, UK., Turton EJ; Clinical Trials Research Unit, Sheffield Centre for Health and Related Research, University of Sheffield, Sheffield, UK., Tappenden P; School of Medicine and Population Health, Sheffield Centre for Health and Related Research, University of Sheffield, Sheffield, UK., White D; School of Medicine and Population Health, Sheffield Centre for Health and Related Research, University of Sheffield, Sheffield, UK., Howard RJ; Division of Psychiatry, University College London, London, UK., Serfaty MA; Division of Psychiatry, University College London, London, UK.; Priory Hospital North London, London, UK., McCracken LM; Department of Psychology, Uppsala University, Uppsala, Sweden., Graham CD; Department of Psychological Sciences & Health, University of Strathclyde, Glasgow, UK., Al-Chalabi A; Maurice Wohl Clinical Neuroscience Institute, King's College London, London, UK., Goldstein LH; Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK., Lawrence V; Health Service & Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK., Cooper C; Clinical Trials Research Unit, Sheffield Centre for Health and Related Research, University of Sheffield, Sheffield, UK., Young T; School of Medicine and Population Health, Sheffield Centre for Health and Related Research, University of Sheffield, Sheffield, UK.
Jazyk: angličtina
Zdroj: European journal of neurology [Eur J Neurol] 2024 Aug; Vol. 31 (8), pp. e16317. Date of Electronic Publication: 2024 Apr 25.
DOI: 10.1111/ene.16317
Abstrakt: Background: Given the degenerative nature of the condition, people living with motor neuron disease (MND) experience high levels of psychological distress. The purpose of this research was to investigate the cost-effectiveness of acceptance and commitment therapy (ACT), adapted for the specific needs of this population, for improving quality of life.
Methods: A trial-based cost-utility analysis over a 9-month period was conducted comparing ACT plus usual care (n = 97) versus usual care alone (n = 94) from the perspective of the National Health Service. In the primary analysis, quality-adjusted life years (QALYs) were computed using health utilities generated from the EQ-5D-5L questionnaire. Sensitivity analyses and subgroup analyses were also carried out.
Results: Difference in costs was statistically significant between the two arms, driven mainly by the intervention costs. Effects measured by EQ-5D-5L were not statistically significantly different between the two arms. The incremental cost-effectiveness was above the £20,000 to £30,000 per QALY gained threshold used in the UK. However, the difference in effects was statistically significant when measured by the McGill Quality of Life-Revised (MQOL-R) questionnaire. The intervention was cost-effective in a subgroup experiencing medium deterioration in motor neuron symptoms.
Conclusions: Despite the intervention being cost-ineffective in the primary analysis, the significant difference in the effects measured by MQOL-R, the low costs of the intervention, the results in the subgroup analysis, and the fact that ACT was shown to improve the quality of life for people living with MND, suggest that ACT could be incorporated into MND clinical services.
(© 2024 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.)
Databáze: MEDLINE
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