Healthcare utilisation and costs associated with poor access to diagnosis and treatment for children and young people with tic disorders.

Autor:	Hall CL; NIHR MindTech MedTech Health Research Centre, Institute of Mental Health, University of Nottingham, Nottingham, UK.; NIHR Nottingham Biomedical Research Centre, Institute of Mental Health, University of Nottingham School of Medicine, Nottingham, UK., Le Novere M; Research Department of Primary Care and Population Health and Priment CTU, University College London, London, UK., Murphy T; University College London Great Ormond Street Institute of Child Health, London, UK.; Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK., McNally E; Tourettes Action, Farnborough, UK., Hollis C; NIHR MindTech MedTech Health Research Centre, Institute of Mental Health, University of Nottingham, Nottingham, UK.; NIHR Nottingham Biomedical Research Centre, Institute of Mental Health, University of Nottingham School of Medicine, Nottingham, UK.; Child and Adolescent Psychiatry, Queen's Medical Centre, Nottingham, UK., Hunter R; Research Department of Primary Care and Population Health and Priment CTU, University College London, London, UK r.hunter@ucl.ac.uk.
Jazyk:	angličtina
Zdroj:	BMJ mental health [BMJ Ment Health] 2024 Nov 07; Vol. 27 (1). Date of Electronic Publication: 2024 Nov 07.
DOI:	10.1136/bmjment-2024-301241
Abstrakt:	Background: There are no specific national guidelines in England to guide healthcare professionals in how to assess or treat young people with tic disorders. Access to evidence-based treatment, including behavioural therapy, is of limited availability. Objectives: This study examined the economic impact on services arising from a lack of access to appropriate healthcare services for young people with tic disorders, alongside the impact on school attendance. Methods: This study used data from the randomised controlled trial 'ORBIT' (Online Remote Behavioural Intervention for Tics). ORBIT compared online exposure and response prevention behavioural therapy for tics with online psychoeducation and recruited 224 young people aged 9-17 years in England. Here, we explore costs of health service use and school absenteeism from children who participated in the ORBIT trial and present these alongside the economic impact of including ORBIT within a tic service. We supplement ORBIT data with findings from two case studies. Findings: The data showed that patients have care from several healthcare professionals and miss school due to accessing care for tics. The case studies suggest that most of these contacts with specialist services are unlikely to be supportive. However, adding ORBIT could save the National Health Service £1 million. Conclusions: Young people with tic disorders are likely to engage in substantial use of healthcare resources because of inadequate care pathways. The availability of an evidence-based online therapy such as ORBIT could save money to the healthcare system. Clinical Implications: There is a need to improve service provision and develop national guidelines for tic disorders. Trial Registration Number: ISRCTN70758207, NCT03483493. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.)
Databáze:	MEDLINE
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