Internet-Based Cognitive Behavioral Therapy for Insomnia: A Health Economic Evaluation

Autor: Matthias Berking, Hanne Thiart, Heleen Riper, Dirk Lehr, Claudia Buntrock, Filip Smit, David Daniel Ebert, Stephanie Nobis
Přispěvatelé: Clinical Psychology, EMGO+ - Mental Health, Clinical, Neuro- & Developmental Psychology, EMGO - Mental health, Epidemiology and Data Science, Psychiatry
Rok vydání: 2016
Předmět:
Zdroj: Thiart, H, Ebert, D D, Lehr, D, Nobis, S, Buntrock, C, Berking, M, Smit, F & Riper, H 2016, ' Internet-Based Cognitive Behavioral Therapy for Insomnia : A Health Economic Evaluation ' SLEEP, vol 39, no. 10, pp. 1769-1778 . DOI: 10.5665/sleep.6152
Thiart, H, Ebert, D D, Lehr, D, Nobis, S, Buntrock, C, Berking, M, Smit, F & Riper, H 2016, ' Internet-Based Cognitive Behavioral Therapy for Insomnia : A Health Economic Evaluation ', Sleep, vol. 39, no. 10, pp. 1769-1778 . https://doi.org/10.5665/sleep.6152
SLEEP, 39(10), 1769-1778. American Academy of Sleep Medicine
Sleep, 39(10), 1769-1778. American Academy of Sleep Medicine
Thiart, H, Ebert, D D, Lehr, D, Nobis, S, Buntrock, C, Berking, M, Smit, F & Riper, H 2016, ' Internet-based cognitive behavioral therapy for insomnia: a health economic evaluation. ', SLEEP, vol. 39, no. 10, pp. 1769-1778 . https://doi.org/10.5665/sleep.6152
ISSN: 1550-9109
0161-8105
DOI: 10.5665/sleep.6152
Popis: STUDY OBJECTIVES: Lost productivity caused by insomnia is a common and costly problem for employers. Although evidence for the efficacy of Internet-based cognitive behavioral therapy for insomnia (iCBT-I) already exists, little is known about its economic effects. This study aims to evaluate the cost-effectiveness and cost-benefit of providing iCBT-I to symptomatic employees from the employer's perspective.METHODS: School teachers (N = 128) with clinically significant insomnia symptoms and work-related rumination were randomized to guided iCBT-I or a waitlist-control-group, both with access to treatment as usual. Economic data were collected at baseline and 6-mo follow-up. We conducted (1) a cost-effectiveness analysis with treatment response (Reliable Change [decline of 5.01 points] and Insomnia Severity Index < 8 at 6-month follow-up) as the outcome and (2) a cost-benefit analysis. Because both analyses were performed from the employer's perspective, we focused specifically on absenteeism and presenteeism costs. Statistical uncertainty was estimated using bootstrapping.RESULTS: Assuming intervention costs of €200 ($245), cost-effectiveness analyses showed that at a willingness-to-pay of €0 for each positive treatment response, there is an 87% probability that the intervention is more cost effective than treatment as usual alone. Cost-benefit analyses led to a net benefit of €418 (95% confidence interval: -593.03 to 1,488.70) ($512) per participant and a return on investment of 208% (95% confidence interval: -296.52 to 744.35). The reduction in costs was mainly driven by the effects of the intervention on presenteeism and to a lesser degree by reduced absenteeism.CONCLUSIONS: Focusing on sleep improvement using iCBT-I may be a cost-effective strategy in occupational health care.CLINICAL TRIALS REGISTRATION: Title: Online Recovery Training for Better Sleep in Teachers with High Psychological Strain. German Clinical Trial Register (DRKS), URL: https://drks-neu.uniklinik-freiburg.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00004700. Identifier: DRKS00004700.COMMENTARY: A commentary on this article appears in this issue on page 1767.
Databáze: OpenAIRE
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