Cost-effectiveness of preventing first-episode psychosis in ultra-high-risk subjects
| Autor: | Don H. Linszen, Lex Wunderink, D.H. Nieman, Filip Smit, Nynke Boonstra, Rianne M. C. Klaassen, N. S. P. Savelsberg, Wim Veling, Helga K. Ising, S. Dragt, Judith Rietdijk, M. van der Gaag |
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| Přispěvatelé: | Psychiatrie & Neuropsychologie, RS: MHeNs - R2 - Mental Health, ANS - Amsterdam Neuroscience, APH - Amsterdam Public Health, Adult Psychiatry, Clinical Psychology, EMGO+ - Mental Health, Perceptual and Cognitive Neuroscience (PCN), Clinical Cognitive Neuropsychiatry Research Program (CCNP), Epidemiology and Data Science, EMGO - Mental health |
| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
Adult
Male Risk medicine.medical_specialty Adolescent Cost effectiveness medicine.medical_treatment Cost-Benefit Analysis Psychological intervention 1ST EPISODE QUESTIONNAIRE ECONOMIC-EVALUATION EARLY INTERVENTION Disease-Free Survival VALIDATION law.invention Outcome Assessment (Health Care) Young Adult Randomized controlled trial law HELP-SEEKING POPULATION Outcome Assessment Health Care medicine Humans psychosis quality-adjusted life years Psychiatry COGNITIVE-BEHAVIORAL THERAPY Applied Psychology health care economics and organizations METAANALYSIS Cognitive Behavioral Therapy ultra-high-risk patients Prevention Cost-effectiveness analysis STATE Quality-adjusted life year Cognitive behavioral therapy Psychiatry and Mental health Cognitive Therapy Psychotic Disorders Economic evaluation Cognitive therapy Physical therapy Female Psychology FOLLOW-UP Follow-Up Studies |
| Zdroj: | Ising, H K, Smit, H F E, Veling, W, Rietdijk, J, Dragt, S, Klaassen, R M C, Savelsberg, N S P, Boonstra, N, Linszen, D H, Wunderink, L & van der Gaag, M 2015, ' Cost-effectiveness of preventing first-episode psychosis in ultra-high-risk subjects: Multi-centre randomized controlled trial ', Psychological Medicine, vol. 45, no. 7, pp. 1435-1446 . https://doi.org/10.1017/S0033291714002530 Psychological Medicine, 45(7), 1435-46. Cambridge University Press Psychological medicine, 45(7), 1435-1446. Cambridge University Press Psychological Medicine, 45(7), 1435-1446. Cambridge University Press |
| ISSN: | 0033-2917 |
| DOI: | 10.1017/s0033291714002530 |
| Popis: | BackgroundAlthough there is evidence for the effectiveness of interventions for psychosis among ultra-high-risk (UHR) groups, health economic evaluations are lacking. This study aimed to determine the cost effectiveness and cost–utility of cognitive–behavioural therapy (CBT) to prevent first-episode psychosis.MethodThe Dutch Early Detection and Intervention Evaluation study was a randomized controlled trial of 196 UHR patients with an 18-month follow-up. All participants were treated with routine care (RC) for non-psychotic disorders. The experimental group (n = 95) received add-on CBT to prevent first-episode psychosis. We report the intervention, medical and travel costs, as well as costs arising from loss of productivity. Treatment response was defined as psychosis-free survival and quality-adjusted life years (QALYs) gained.ResultsIn the cost-effectiveness analysis, the proportion of averted psychoses was significantly higher in the CBT condition (89.5% v. 76.2%). CBT showed a 63.7% probability of being more cost effective, because it was less costly than RC by US$844 (£551) per prevented psychosis. In the cost–utility analysis, QALY health gains were slightly higher for CBT than for RC (0.60 v. 0.57) and the CBT intervention had a 52.3% probability of being the superior treatment because, for equal or better QALY gains, the costs of CBT were lower than those of RC.ConclusionsAdd-on preventive CBT for UHR resulted in a significant reduction in the incidence of first psychosis. QALY gains show little difference between the two conditions. The CBT intervention proved to be cost saving. |
| Databáze: | OpenAIRE |
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